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中华普外科手术学杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 456 -460. doi: 10.3877/cma.j.issn.1674-3946.2023.04.027

综述

近端胃切除术后消化道重建方式的研究进展
黄勇, 郑智, 张海翘, 王龙, 辛城霖, 刘小野, 尹杰(), 张军   
  1. 100050 北京,首都医科大学附属北京友谊医院普外科,国家消化系统疾病临床医学研究中心
  • 收稿日期:2022-11-28 出版日期:2023-08-26
  • 通信作者: 尹杰

Research progress of digestive tract reconstruction after proximal gastrectomy

Yong Huang, Zhi Zheng, Haiqiao Zhang, Long Wang, Chenglin Xin, Xiaoye Liu, Jie Yin(), Jun Zhang   

  1. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Nation Clinical Research Center For Digestive Diseases, Beijing 100050, China
  • Received:2022-11-28 Published:2023-08-26
  • Corresponding author: Jie Yin
引用本文:

黄勇, 郑智, 张海翘, 王龙, 辛城霖, 刘小野, 尹杰, 张军. 近端胃切除术后消化道重建方式的研究进展[J]. 中华普外科手术学杂志(电子版), 2023, 17(04): 456-460.

Yong Huang, Zhi Zheng, Haiqiao Zhang, Long Wang, Chenglin Xin, Xiaoye Liu, Jie Yin, Jun Zhang. Research progress of digestive tract reconstruction after proximal gastrectomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(04): 456-460.

目前,根治性全胃切除术仍是治疗食管胃接合部腺癌(AEG)的主要方式,但是由于早期AEG远端淋巴结转移率低,如果不加选择的进行全胃切除术会导致部分患者接受不必要的淋巴结清扫,增加手术创伤,严重影响患者术后生活质量。因此,早期AEG如何能够在保证肿瘤根治性的前提下,最大程度降低手术创伤、保留部分胃功能,从而提高患者生活质量,逐渐成为学者们关注的焦点。近年来,国内外越来越多的学者推荐近端胃切除术,其优势在于术后具有更佳的生活质量,不足在于具有较高的胃食管反流和吻合口狭窄发生率,因此,为了改善这一不足,众多新型吻合方式包括Side-overlap吻合、双肌瓣吻合、空肠间置、双通道吻合等方式应运而生。但是,目前国内外指南对于如何选择最佳的近端胃消化道重建方式仍无共识或指南。因此,本文就近端胃切除术后消化道重建方式的进展作一综述,希望为最佳吻合方式的选择提供参考。

At present,radical total gastrectomy is still the main treatment method for esophagogastric junction adenocarcinoma(AEG). However,due to the low rate of distal lymph node metastasis in early AEG,total gastrectomy without any choice may lead to unnecessary lymph node dissection in some patients,increase surgical trauma,and seriously affect the postoperative quality of life of patients. Therefore,how early AEG can minimize surgical trauma,preserve part of gastric function and improve patients’quality of life on the premise of ensuring the radical treatment of tumors has gradually become the focus of scholars. In recent years,more and more scholars at home and abroad recommend proximal gastrectomy,which has the advantages of better postoperative quality of life,and the disadvantages of higher gastroesophageal reflux and anastomotic stenosis rate. Therefore,in order to improve this deficiency,Many new anastomotic methods,including Side-overlap,double muscle flap anastomosis,jejunal interposition and double channel anastomosis,emerged. However,there is no consensus or guideline on how to choose the best proximal gastro-digestive reconstruction. Therefore,this article reviews the progress of digestive tract reconstruction after proximal gastrectomy,hoping to provide reference for the selection of the best anastomotic method.

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