Pandey Kalyan, Devi Padmalaya, Das Prafulla Kumar, Mohanty Swodeep, Goutam Kunal, Samantara Subrat, Satpathy Bharat Bhushan, Patil Nilesh, Khadia Mohanlal, Lenka Subhransu Sekhar
Department of Surgical Oncology, Acharya Harihar Regional Cancer Centre, Cuttack, 753007 India.
Indian J Surg Oncol. 2021 Jun;12(2):290-297. doi: 10.1007/s13193-021-01288-7. Epub 2021 Mar 6.
The only hope of cure in carcinoma stomach is gastrectomy; it can be total or partial depending upon the location of the tumor. While there is no controversy in the extent of resection, the choice of anastomosis after partial gastrectomy is a matter of debate. For pyloric lesions, we felt that in spite of the ease of performing surgery, simplicity, being physiological, and time-saving, Billroth I is underutilized. Hence, the study rationale was to compare Billroth I and Billroth II anastomosis post-gastric resection in the surgical management of gastric cancer. This was a retrospective study performed in the Department of Surgical Oncology, Acharya Harihar Regional Cancer Centre (AHRCC), Cuttack, Odisha. A total of 95 patients who underwent distal radical gastrectomy for gastric cancer during 2016 and 2017 were included in the study. Nineteen patients underwent Billroth I reconstruction and 76 patients underwent Billroth II reconstruction. In the case of both groups, no statistically significant differences (.05) were found in terms of early post-operative complications or long-term post-operative follow-up in our experience. Billroth I reconstruction is a simple, oncologically safe, economical, and physiological procedure. It can be performed when there is availability of large stomach remnant post-gastric resection. However, there is no significant difference between Billroth I and Billroth II in terms of patient's recovery and post-operative complications.
胃癌唯一的治愈希望是胃切除术；根据肿瘤位置可进行全胃切除或部分胃切除。虽然在切除范围上没有争议，但部分胃切除术后吻合方式的选择仍存在争议。对于幽门部病变，我们认为尽管毕罗Ⅰ式手术操作简便、简单、符合生理且节省时间，但应用不足。因此，本研究的目的是比较毕罗Ⅰ式和毕罗Ⅱ式吻合在胃癌手术治疗中的效果。这是一项在奥里萨邦科塔克市阿查里亚·哈里哈区域癌症中心（AHRCC）外科肿瘤学部门进行的回顾性研究。共有95例在2016年至2017年期间因胃癌接受远端根治性胃切除术的患者纳入研究。19例患者接受了毕罗Ⅰ式重建，76例患者接受了毕罗Ⅱ式重建。根据我们的经验，两组在术后早期并发症或长期术后随访方面均未发现统计学上的显著差异（P>0.05）。毕罗Ⅰ式重建是一种简单、肿瘤学上安全、经济且符合生理的手术方法。当胃切除术后有足够大的胃残端时即可进行。然而，在患者恢复和术后并发症方面，毕罗Ⅰ式和毕罗Ⅱ式之间没有显著差异。
