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近端胃切除术后消化道重建方式的现状与展望

Current situation and prospect of digestive tract reconstruction after proximal gastrectomy
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摘要 近年来,对于局部早期、无转移的胃上部癌,近端胃切除术被认为是一种保留胃功能、提高术后生活质量的手术方式。相较于全胃切除术,近端胃切除术在减轻体重、改善营养状态方面具有显著优势。然而,由于术后易发生反流性食管炎和吻合口狭窄等并发症,如何在术后进行胃食管结合部的有效重建,既保留胃功能又降低并发症的发生率,成为当前研究的热点。本文梳理并总结了胃食管结合部解基础及近端胃切除术后消化道重建方式的研究进展,并探讨了不同重建方式的优缺点和在临床应用中的效果,旨在为临床医师提供参考,以期提高近端胃切除术后患者的预后和生活质量。 In recent years,proximal gastrectomy has been considered as a surgical option to preserve gastric function and improve postoperative quality of life for locally early,non-metastatic upper gastric cancer.Compared with total gastrectomy,proximal gastrectomy has significant advantages in reducing weight loss and improving nutritional status.However,due to postoperative complications such as reflux esophagitis and anastomotic stenosis,how to effectively reconstruct the gastroesophageal junction after surgery to preserve gastric function and reduce the incidence of complications has become a focus of current research.This article reviewed and summarized the anatomical basis of the gastroesophageal junction and the research progress of digestive tract reconstruction methods after proximal gastrectomy,and discussed the advantages and disadvantages of different reconstruction methods and their effects in clinical application,aiming to provide a reference for clinicians to improve the prognosis and quality of life of patients after proximal gastrectomy.
作者 李临川 李戊阳 程玉刚 朱健康 张光永 Li Linchuan;Li Wuyang;Cheng Yugang;Zhu Jiankang;Zhang Guangyong(Department of General Surgery,The First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Shandong 255013,China;Laboratory of Metabolism and Gastrointestinal Tumor,Shandong Provincial Qianfoshan Hospital,The First Affiliated Hospital of Shandong First Medical University,Shandong 255013,China)
出处 《中华腔镜外科杂志(电子版)》 2024年第3期135-140,共6页 Chinese Journal of Laparoscopic Surgery(Electronic Edition)
关键词 近端胃切除术 消化道重建 预后 生活质量 Proximal gastrectomy Digestive tract reconstruction Prognosis Quality of life
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