Kano Kazuki, Cho Haruhiko, Maezawa Yukio, Aoyama Toru, Hayashi Tsutomu, Yamada Takanobu, Sato Tsutomu, Oshima Takashi, Yukawa Norio, Rino Yasushi, Masuda Munetaka, Ogata Takashi, Yoshikawa Takaki
Dept. of Gastrointestinal Surgery, Kanagawa Cancer Center.
Gan To Kagaku Ryoho. 2017 Oct;44(10):929-931.
A 53-year-old man underwentdistal gastrectomy with Roux-en-Y(R-Y)reconstruction for gastric cancer. An R-Y anastomosis was performed usinga 21mm circular stapler. Five years postoperatively, he visited our hospital with anorexia. An abdominal computed tomography scan showed dilatation of the afferent loop. He was diagnosed with afferent loop syndrome due to R-Y anastomotic stenosis that resulted in poor oral intake and malnutrition. A U-shaped bend created by an adhesion caused a bowel obstruction of the Y-anastomotic site for which the patient underwent R-Y loop reconstruction with an aboral pouch usinga 60mm linear stapler. He has been well without postoperative complaints. Here, we report a case of R-Y loop reconstruction with an aboral pouch for afferent loop obstruction complicated by stenosis of the Y-anastomotic site after distal gastrectomy.
一名53岁男性因胃癌接受了远端胃切除术并进行Roux-en-Y（R-Y）重建。使用21mm圆形吻合器进行了R-Y吻合。术后五年，他因厌食前来我院就诊。腹部计算机断层扫描显示输入袢扩张。他被诊断为因R-Y吻合口狭窄导致摄入不足和营养不良的输入袢综合征。粘连形成的U形弯曲导致Y形吻合口处肠梗阻，为此患者使用60mm直线吻合器进行了带输出襻的R-Y袢重建。术后他恢复良好，无不适主诉。在此，我们报告一例远端胃切除术后因Y形吻合口狭窄并发输入袢梗阻而进行带输出襻的R-Y袢重建的病例。
