Uras C, Yigitbasi R, Erturk S, Hamzaoglu I, Sayman H
Department of General Surgery, Cerrahpasa Medical Faculty, University of Istanbul, Turkey.
Br J Surg. 1997 Mar;84(3):406-9.
A wide range of inevitable adverse effects may emerge after total gastrectomy, mainly due to loss of reservoir organ and exclusion of the duodenal route. None of the available reconstructive methods has achieved a satisfactory functional result. A new method has been tried to overcome postgastrectomy problems.
In this preliminary clinical study, a reconstruction technique involving interposition of the ileocaecal segment as a gastric substitute after pylorus-preserving near-total gastrectomy (restorative caecogastroplasty) was applied in six selected patients with proximal gastric carcinoma.
Postoperative radiological and scintigraphic studies revealed adequate reservoir capacity, satisfactory neogastric emptying and a well functioning pyloric mechanism. During mean follow-up of 15 (range 3-36) months, dumping syndrome, reflux oesophagitis and weight loss were not observed.
It is suggested that restorative caecogastroplasty combines the advantages of intact sphincter mechanisms and maintaining the duodenal route as well as sufficient reservoir volume. This method can be used safely as an alternative to other methods of reconstruction.
全胃切除术后可能会出现一系列不可避免的不良反应，主要是由于储存器官的丧失和十二指肠路径的排除。现有的重建方法均未取得令人满意的功能效果。已尝试一种新方法来克服胃切除术后的问题。
在这项初步临床研究中，对6例经选择的近端胃癌患者应用了一种重建技术，即在保留幽门的近全胃切除术后将回盲部作为胃替代物进行间置（恢复性盲肠胃成形术）。
术后影像学和闪烁扫描研究显示有足够的储存容量、满意的新胃排空及良好的幽门机制功能。在平均15个月（范围3 - 36个月）的随访期间，未观察到倾倒综合征、反流性食管炎和体重减轻。
提示恢复性盲肠胃成形术结合了完整括约肌机制、维持十二指肠路径以及足够储存容量的优点。该方法可作为其他重建方法的安全替代方法使用。
