摘要
胃癌是常见的恶性肿瘤,近年来近端胃癌和食管胃结合部腺癌发生率明显增加。多项研究表明,对于近端胃癌或食管胃结合部腺癌,当肿瘤直径≤4 cm,无论浸润深度,此时淋巴结转移到第4、第5、第6组淋巴结的可能性很低。对于早期近端胃癌和食管胃结合部腺癌,近端胃切除术与全胃切除术5年总体生存率相当。近端胃切除术在术后保留残胃和幽门功能、改善患者营养状况方面更有优势。针对近端胃切除术术后反流性食管炎,有多种重建术式。其中,双浆肌瓣吻合术具有良好的抗反流效果,可以明显减少食物残留发生率,提高了患者术后生存质量,实现了现代胃癌外科“个体化-精准化-保功能-重质量”的要求。
Gastric cancer is a common malignant tumor,and in recent years,the incidence of proximal gastric cancer and gastroesophageal junction adenocarcinoma has significantly increased.Multiple studies have shown that for proximal gastric cancer or gastroesophageal junction adenocarcinoma,when the tumor diameter is ≤4 cm,regardless of the depth of infiltration,the likelihood of lymph node metastasis to the No.4,No.5 and No.6 groups is very low.For early proximal gastric cancer and gastroesophageal junction adenocarcinoma,proximal gastrectomy has a comparable 5-year overall survival rate to total gastrectomy.Proximal gastrectomy has advantages in preserving remnant stomach and pyloric function after operation,as well as improving the nutritional status of patients.Various reconstruction procedures are available for postoperative reflux esophagitis after proximal gastrectomy.Among them,double seromuscular flap technique has good anti-reflux effects,significantly reducing the occurrence of food residue and improving the postoperative survival quality of patients,meeting the requirements of modern gastric cancer surgery for individualization,precision,functional preservation,and quality improvement.
作者
韩方海
谢烨权
HAN Fanghai;XIE Yequan(Department of Gastrointestinal Surgery,Guangdong Second Provincial General Hospital,Guangzhou 510317,China)
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2024年第4期531-538,共8页
China Journal of General Surgery
关键词
胃肿瘤
胃切除术
双肌瓣吻合术
Stomach Neoplasms
Gastrectomy
Double Seromuscular Flap Technique
