摘要
近年来,我国早期胃上部癌检出率升高。早期胃上部癌预后好,提升患者术后生命质量,成为广受关注的问题。因此,保功能的近端胃切除术应运而生。但近端胃切除术由于破坏贲门及附近原有结构,术后容易出现反流。防止术后反流的消化道重建方式较多,但最佳的消化道重建方式仍有争议。因此,选择合适的消化道重建方式,减少术后反流发生,是近端胃切除术的重点。食管胃肌瓣吻合术在保证食物正常进入消化道的基础上构建“人工贲门”,发挥术后抗反流作用。由于良好的抗反流效果,食管胃肌瓣吻合法逐渐成为研究热点。笔者结合国内外最新研究动态和相关循证医学证据,对腹腔镜近端胃切除食管胃肌瓣吻合术的原理、要点、改良、术后状态、应用情况等方面进行综述。
In the past few years,there has seen an increase in the detection rate of early upper gastric cancer.Early upper gastric cancer is of good prognosis.How to further enhance the postoperative quality of life of patients has increasingly become an issue of concern.This has naturally given rise to function-preserving proximal gastrectomy.However,due to its damage to the original structure of cardia and its vicinity,proximal gastrectomy is prone to postoperative reflux.To prevent postoperative reflux,various ways of digestive tract reconstruction have emerged one after another,but the optimal way thereof remains controversial.Therefore,reducing postoperative reflux through an appropriate way of digestive tract reconstruction has been taken as a focus of proximal gastrectomy.Esophagogastric anastomosis with seromuscular flap technique,as a way of digestive tract reconstruction,builds an"artificial cardia"on the basis of guarantee of normal entry of food into the digestive tract,and functions against postoperative reflux.For its good anti-reflux effect,esophagogastric anastomosis with seromuscular flap technique has gradually become a research focus.On top of the latest research progress at home and abroad and relevant evidence-based medicine,the authors provide on the principles,key points,improvement,postoperative status,and application of esophagogastric anastomosis with seromuscular flap technique in laparoscopic proximal gastrectomy.
作者
吴楚营
许建华
林建安
钟文进
康文贵
王金填
陈俊兴
郑辉达
叶凯
Wu Chuying;Xu Jianhua;Lin Jian′an;Zhong Wenjin;Kang Wengui;Wang Jintian;Chen Junxing;Zheng Huida;Ye Kai(Department of Gastrointestinal and Esophageal Surgery,The Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2023年第S01期101-105,共5页
Chinese Journal of Digestive Surgery
基金
福建省临床重点专科建设项目(闽卫医政函[2022]884号)
关键词
胃肿瘤
近端胃
消化道重建
抗反流
肌瓣
腹腔镜检查
Stomach neoplasms
Proximal gastric
Digestive tract reconstruction
Antireflux
Seromuscular flap
Laparoscopy
