Collard J M, Tinton N, Malaise J, Romagnoli R, Otte J B, Kestens P J
Department of Surgery, Louvain Medical School, Brussels, Belgium.
Ann Thorac Surg. 1995 Aug;60(2):261-6; discussion 267. doi: 10.1016/0003-4975(95)00411-d.
The stomach can be used either in its entirely or as a greater curvature tube for esophageal replacement.
The study compares the gastric tube (group A; n = 112) to the whole stomach whose lesser curvature is denuded (group B; n = 100) in terms of technical complication and alimentary comfort. The clinical results are substantiated by assessment of the eating performance of patients and control subjects at a test meal, measurement of the gastric dimensions before and after both tailoring procedures, and intraarterial staining of the gastric wall.
Major differences between the two groups are cervical anastomosis stenoses (22.3% versus 6% [A versus B]; p = 0.008), fistulas (7.9% versus 1%; p = 0.0209), number of meals and snacks per day (4.6 versus 4; p = 0.0275), sensation of early fullness at meals (52.4% versus 17.8%; p < 0.0001), ratings given to the long-term alimentary comfort (presymptomatic condition = 10 points) (7.6 versus 8.8 out of 10 on average; p < 0.0001), and calories consumed in 1 minute at a test meal (59% [p < 0.05] versus 77% of those consumed by control subjects). The volume of the stomach is reduced by a range of 21.4% to 47.2% after tubulization (group A) whereas it increases by a range of 4.9% to 17.4% after denudation of the lesser curve (group B). Intraarterial staining of the gastric wall reveals the poor vascularity of the upper-most segment of the greater curve.
Slight increase of the gastric capacity and maintenance of the submucosal vascular network account for the better results achieved with the whole stomach.
胃既可以整体使用，也可以作为胃大弯管用于食管置换。
本研究在技术并发症和饮食舒适度方面，将胃管组（A组；n = 112）与小弯侧剥脱的全胃组（B组；n = 100）进行比较。通过对患者和对照受试者在试餐时的进食表现进行评估、测量两种裁剪手术后胃的尺寸以及胃壁的动脉内染色，来证实临床结果。
两组之间的主要差异在于颈部吻合口狭窄（22.3% 对6% [A组对B组]；p = 0.008）、瘘（7.9% 对1%；p = 0.0209）、每天进餐和吃零食的次数（4.6次对4次；p = 0.0275）、进餐时的早期饱腹感（52.4% 对17.8%；p < 0.0001）、对长期饮食舒适度的评分（无症状状态 = 10分）（平均10分中7.6分对8.8分；p < 0.0001）以及试餐时1分钟内消耗的卡路里（对照组消耗卡路里的59% [p < 0.05] 对77%）。胃管化后（A组）胃的体积减少了21.4%至47.2%，而小弯侧剥脱后（B组）胃的体积增加了4.9%至17.4%。胃壁的动脉内染色显示胃大弯最上段的血管供应较差。
胃容量的轻微增加和黏膜下血管网络的维持是全胃取得更好效果的原因。
