Takahashi M, Tu B L, Leombruni E, Kelly K A
Department of Surgery, Mayo Clinic Scottsdale, Scottsdale, AZ 85259, USA.
J Gastrointest Surg. 1997 Nov-Dec;1(6):545-53. doi: 10.1016/s1091-255x(97)80071-6.
The aim of this study was to determine whether the use of an ileal Roux limb, rather than a jejunal Roux limb, would prevent the Roux stasis syndrome that can occur after Roux gastrectomy. An ileal Roux limb was constructed in eight dogs and anastomosed to the gastric remnant after distal hemigastrectomy. Flow of chyme through the jejunum was preserved via an ileojejunostomy and a jejunoileostomy. Six dogs with distal gastrectomy and a conventional Roux gastrojejunostomy served as a control group. Chronic enteric recording electrodes and intraluminal, open-tipped pressure catheters were implanted in all dogs. After recovery, the electrical activity and motility of the Roux limbs and the rates of gastric emptying of liquids and solids were measured. Dogs with a Roux gastroileostomy had a slower frequency of pacesetter potentials in the Roux limb, a greater Roux motility index, and a faster rate of gastric emptying of liquids and solids than did dogs with a Roux gastrojejunostomy. Stomal ulcers, however, developed in seven of the eight ileal Roux limbs but in none of the jejunal Roux limbs. It was concluded that Roux gastroileostomy does ameliorate the Roux stasis syndrome, but there is a greater risk of stomal ulceration in the limb.
本研究的目的是确定使用回肠Roux袢而非空肠Roux袢是否能预防Roux胃切除术后可能出现的Roux淤滞综合征。在8只犬中构建回肠Roux袢,并在远端胃切除术后将其与胃残端吻合。通过回肠空肠吻合术和空肠回肠吻合术保持食糜通过空肠的流动。6只接受远端胃切除术并进行传统Roux胃空肠吻合术的犬作为对照组。在所有犬中植入慢性肠记录电极和腔内开口尖端压力导管。恢复后,测量Roux袢的电活动和运动性以及液体和固体食物的胃排空率。与接受Roux胃空肠吻合术的犬相比,接受Roux胃回肠吻合术的犬Roux袢中起搏电位频率较慢,Roux运动指数较高,液体和固体食物的胃排空率较快。然而,8个回肠Roux袢中有7个出现吻合口溃疡,而空肠Roux袢均未出现。得出的结论是,Roux胃回肠吻合术确实能改善Roux淤滞综合征,但该袢发生吻合口溃疡的风险更大。