Klotz H P, Largiadèr F
Departement Chirurgie, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1994 Aug 20;124(33):1442-6.
Since the first gastric resection performed by Theodor Billroth in 1881, there has been discussion about the best method of reconstruction following gastric resection. Because of its high incidence of anastomotic ulcers, the method of Roux-en-Y reconstruction was abandoned at the beginning of the 20th century. In the late 1970s, when the first gastric stump carcinomas became known, Roux-en-Y reconstruction rose to become the method of choice for reconstruction following gastric resection. The main advantage of the method is in preventing high gastroduodenal reflux and thus averting the development of gastric stump carcinoma. When it is combined with total antrectomy and vagotomy, the rate of anastomotic ulcers is negligible and patients benefit from an improved longterm functional result.
自1881年西奥多·比尔罗特首次进行胃切除术后，关于胃切除术后最佳重建方法的讨论就一直存在。由于吻合口溃疡发生率高，Roux-en-Y重建法在20世纪初被弃用。20世纪70年代末，首例胃残端癌被发现后，Roux-en-Y重建法又成为胃切除术后重建的首选方法。该方法的主要优点是能防止高度的胃十二指肠反流，从而避免胃残端癌的发生。当它与全胃窦切除术和迷走神经切断术结合时，吻合口溃疡的发生率可忽略不计，患者能从长期功能改善中获益。
