不同消化道重建方式与胃切除术后消化道梗阻关系

发布时间：2018-10-26 11:36

【摘要】：外科技术和手术器械的进步给胃切除术带来了各种革新,术后消化道梗阻发生原因也趋于多样化、复杂化,涉及原发疾病、术式选择、吻合方法等多种因素。术后吻合口狭窄或梗阻可发生在胃-十二指肠、胃-空肠、食管-空肠、食管-残胃等多种吻合中,与吻合方式和吻合器械的选择、瘢痕或肿瘤复发关系密切。输入袢或输出袢梗阻仍然是困扰着外科医生的重要并发症之一,输入袢问题更多见。Roux-en-Y吻合上举空肠臂也可能发生一些特有的消化道梗阻,包括上举肠臂肠管套叠、内疝、Roux滞留综合征等。此外,胃瘫、粘连性肠梗阻也时有发生。疾病谱的改变和胃肠外科的发展,使胃切除术后消化道梗阻发生原因、特点均出现了很大变化,需要临床医生发扬工匠精神,精益求精,不断总结临床经验。
[Abstract]:The progress of surgical techniques and instruments has brought various innovations to gastrectomy, and the causes of postoperative gastrointestinal obstruction tend to be diversified and complicated, involving many factors, such as primary diseases, operation selection, anastomosis methods, and so on. Anastomotic stricture or obstruction may occur in gastroduodenal gastrojejunum esophagogastric remnant stomach anastomosis and so on. It is closely related to the choice of anastomosis instruments scar or tumor recurrence. Obstruction of the input or output loops is still one of the major complications for surgeons, and problems with the input loops are more common. Some unique gastrointestinal obstruction may occur in the upper arm of the Roux-en-Y anastomosis, including intussusception of the upper arm. Internal hernia, Roux retention syndrome, etc. In addition, gastroparesis, adhesive intestinal obstruction also occurs from time to time. The changes of disease spectrum and the development of gastrointestinal surgery have caused great changes in the causes and characteristics of gastrointestinal obstruction after gastrectomy. It is necessary for clinicians to carry forward the craftsmanship, to strive for perfection and to sum up the clinical experience.
【作者单位】：天津医科大学总医院胃肠外科天津普通外科研究所;
【分类号】：R656

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