摘要
早期胃癌相对于进展期胃癌,淋巴结转移发生率低、预后较好,因此功能保留胃切除手术被广泛探索,并运用于早期癌患者的治疗中。对于食管胃结合部早期腺癌,根治性近端胃切除术与全胃切除相比,5年总生存率未见明显差异,同时具有术后胃部分功能保留、患者营养状态好的优点。近端胃癌根治术后消化道重建的方法有很多,如食管-管状胃吻合、空肠间置吻合、双通道吻合、Kamikawa吻合等,以及我国学者开展的giraffe吻合、胃间置吻合,这些重建方式降低了近端胃根治术后反流性食管炎等的发生。但目前尚缺乏重建标准方案。该文回顾了关于近端胃切除术后重建方式的文献,梳理消化道重建方式的演变和研究进展,期望为系统评估近端胃癌切除术后保留胃功能手术的改进及选择提供参考。
Early stage gastric cancer has low lymph node metastasis incidence and favorable prognosis.The function-preserving gastrectomy(FPG)can acquire similar survival outcomes comparing with total gastrectomy(TG).In addition,FPG can improve the nutritional situation and life quality of patients after surgery.For early gastric cancer in upper third of stomach or AEG,proximal gastrectomy(PG)can be the alternative treatment strategy to TG.But the achilles heel of PG are esophageal reflux and remnant stomach emptying problem.Several reconstruction methods were developed to overcome these disadvantages,including tube stomach,jejunal interposition,jejunal pouch interposition,double tract jejunal interposition and kamikawa method et al.The author made a comprehensive retrospection of articles about reconstruction methods post-PG.Each reconstruction has its own advantages and improves the complications after PG,but there is no standard reconstruction strategy up to now.In future,more randomized controlled trials placing emphasis on evaluation of preserved function after PG should be needed to determine the optimal reconstruction technique.
作者
章旭
邵鹏
周斌
陈环球
ZHANG Xu;SHAO Peng;ZHOU Bin;CHEN Huanqiu(Department of General Surgery,Jiangsu Cancer Hospital/Jiangsu Cancer Research Institue/Cancer Hospital Affiliated to Nanjing Medical University, Nanjing 210009,China)
出处
《中国肿瘤外科杂志》
CAS
2021年第5期436-440,共5页
Chinese Journal of Surgical Oncology
基金
江苏省卫健委面上项目(H2017034)
江苏省肿瘤医院科研项目(ZN201605)。
关键词
近端胃切除
保功能重建
功能评价
Proximal gastrectomy
Function-preserving reconstruction
Function evaluation
