[1]陈群清,陈燕春,闫玉生,等.带血管蒂空肠在重建消化道中的应用[J].南方医科大学学报,2004,(02):238-239.
 CHEN Qun-qing,CHEN Yan-chun,YAN Yu-sheng,et al.Application of jejunum with vascular pedicle in reconstruction of the digestive tract[J].Journal of Southern Medical University,2004,(02):238-239.
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带血管蒂空肠在重建消化道中的应用()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2004年02期
页码:
238-239
栏目:
出版日期:
2004-02-01

文章信息/Info

Title:
Application of jejunum with vascular pedicle in reconstruction of the digestive tract
作者:
陈群清1 陈燕春2 闫玉生1 童健1 孙耀昌3
1. 第一军医大学珠江医院心胸外科, 广东, 广州, 510282;
2. 海军第421医院放射科, 广东, 广州, 510318;
3. 第二军医大学长征医院胸心外科, 上海, 200003
Author(s):
CHEN Qun-qing1 CHEN Yan-chun2 YAN Yu-sheng1 TONG Jian1 SUN Yao-chang3
1. Department of Cardiothoracic Surgery, Zhujiang Hospital, First Military Medical University, Guangzhou 510282, China;
2. 421 Naval Hospital of PLA, Guangzhou 510318, China;
3. Department of Thoracic and Cardiac Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
关键词:
空肠血管蒂食管肿瘤贲门肿瘤消化道重建
Keywords:
jejunumvascular pedicleesophageal neoplasmscardia neoplasmsdigestive tract reconstruction
分类号:
R655.4
摘要:
目的 应用带血管蒂空肠替代食管、胃重建消化道,观察空肠代食管、胃的手术效果及患者的术后生活质量。方法 全组25例患者,其中行近端胃次全切除“P”型襻空肠间置10例;全胃切除主动脉弓下“P”型襻空肠-食管吻合术13例;全胃切除主动脉弓上空肠-食管吻合术2例。术后3个月进行食管内pH值监测,钡餐、胃镜检查,并观察患者的生活质量。结果 全组术后无吻合口漏及胸腹腔感染发生;患者术后均进食通畅,无明显返流性食管炎症状及病理征象;食管pH值均在5.5~6.6。术后存活5年以上8例。结论 带血管蒂空肠代食管、胃重建消化道术式,尤其是对食管中下段癌、贲门癌的效果确切,并发症低,术后生活质量良好,值得推广应用。
Abstract:
Objective To reconstruct the digestive tract using the jejunum with vascular pedicle after esophagectomy or gastrectomy, and observe the therapeutic effects and the patients’ quality of life after the operation. Methods This study included a total of 25 patients, 10 of whom received proximal subtotal gastrectomy followed by reconstruction of the digestive tract with P-shaped jejunum for anastomosis of the esophagus and the residual stomach, 15 had total gastrectomy and anastomosis of the P-shaped jejunum with the esophagus inferior to the arch of aorta, with another 2 having total gastrectomy and the anastomosis superior to the arch of aorta. The pH value of the esophagus was tested, barium meal and gastroscopy were carried out 3 months after the operations, and the patients’ quality of life assessed. Results Anastomotic leakage or infections in the thoracic or abdominal cavity occurred in none of the patients. All the patients had no postoperative difficulty in eating cooked rice, and were free of reflux esophagitis and burning sensation in the chest. The pH value of the esophagus was 5.5-6.6. Eight patients survived for more than 5 years. Conclusions The effects of digestive tract reconstruction using the jejunum with vascular pedicle after esophagectomy or gastrectomy are satisfactory, especially in patients with esophageal cancer in the lower section or cardia cancer. This operation gives rise to low rate of operative complications, and insures good quality of life of the patients.

参考文献/References:

[1] 齐战,陈万生.食管癌切除术后胸胃的生理功能[J].实用癌症杂志(Pract J Cancer),2001,16(2):219-21.
[2] 程帮昌,高尚志.结肠代食管术的临床研究进展[J].中国胸心血管外科临床杂志(Chin J Clin Thorac Cardiavasc Surg),2000,7(1):47-50.
[3] Kono K, Iizuka H, Sekikawa T, et al. Improved quality of life with jejunal pouch reconstruction after total gastrectomy[J]. Am J Surg,2003, 185(2): 150-4.
[4] 姜平,欧阳琦,童新康.不需吻接血管的空肠代食管的应用解剖[J].解剖学杂志,1992,15(2):82-4.Jiang P, Ouyang J, Tong XK, et al. Applied anatomy of esophageal replacement with jejunum without vascular anastomosis[J]. Chin J Anat, 1992, 15(2): 82-4.

相似文献/References:

[1]陈建新,江冠铭,李瑞平,等.空肠多发肉瘤样癌术后肺、脑转移:1例报告并文献复习[J].南方医科大学学报,2017,(12):1695.

备注/Memo

备注/Memo:
收稿日期:2003-8-6。
作者简介:陈群清(1966-),男,福建福州人,1998年毕业于第二军医大学胸心外科专业,博士,主治医师、讲师,电话:020-61643279
更新日期/Last Update: 1900-01-01