Nakaya S, Mizuno H, Ohyanagi H, Saitoh Y
Nihon Geka Gakkai Zasshi. 1985 Sep;86(9):1161-4.
The effects of gastrectomies and those reconstructions for gastric cancer on gut hormone release, GI tract transit time, RISA absorption test and triolein digestion and absorption test were investigated clinically. The patient's quality of life was evaluated by the reconstructive methods. In the cardiectomy type, gut hormone response was markedly increased. The transit time was significantly shortened. In the Billroth I and the interposition types, gut hormone response was slightly decreased. The transit time was normal. In the Billroth II and the Roux-en-Y types, gut hormone response was decreased. The transit time was prolonged. Serum glucose was markedly increased in the Roux-en-Y type. Absorption in protein was depressed in Billroth II and that in fat in Roux-en-Y. Quality of life was best in Billroth I, Billroth II, interposition, Roux-en-Y and cardiectomy in descending order. Postoperative changes of gut hormones and metabolism and the quality of life are influenced by the type of reconstructive procedure. For this reason, for the surgical treatment of cancer of the stomach, it would seem that partial, not total, gastrectomy is more appropriate if meeting the conditions of radical cancer treatment. Moreover, it seems to be indicated that a reconstructive procedure which allows food to pass through the duodenum is the procedure to choose.
临床上研究了胃癌胃切除术及其重建术对肠道激素释放、胃肠道转运时间、放射性碘标记的油酸吸收试验以及三油酸甘油酯消化吸收试验的影响。通过重建方法评估患者的生活质量。在贲门切除类型中，肠道激素反应明显增加。转运时间显著缩短。在毕Ⅰ式和间置类型中，肠道激素反应略有下降。转运时间正常。在毕Ⅱ式和Roux-en-Y类型中，肠道激素反应下降。转运时间延长。Roux-en-Y类型中血清葡萄糖明显升高。毕Ⅱ式中蛋白质吸收降低，Roux-en-Y中脂肪吸收降低。生活质量在毕Ⅰ式、毕Ⅱ式、间置、Roux-en-Y和贲门切除中依次递减。肠道激素和代谢的术后变化以及生活质量受重建手术类型的影响。因此，对于胃癌的手术治疗，如果符合根治性癌症治疗的条件，似乎部分胃切除术而非全胃切除术更合适。此外，似乎表明允许食物通过十二指肠的重建手术是首选的手术方式。
