近端胃切除术后消化道重建的研究现状

Current status of digestive tract reconstruction after proximal gastrectomy

  • 摘要: 包括早期胃癌在内的胃上部1/3胃癌发病率在我国、韩国和日本呈上升趋势。早期胃癌行功能保留手术应尽量减少术后并发症和提高术后生命质量。近端胃切除术能切除肿瘤同时保留部分胃组织,有利于改善病人术后营养状况,提高术后生命质量。但是近端胃切除术后食管括约肌和His角丧失,病人出现反酸、反流,导致反流性食管炎发生,影响术后生命质量。为提高手术疗效,临床医师选择不同消化道重建方法抗反流。目前消化道重建方法种类较多、争议较大。笔者综合分析国内外相关研究进展,系统阐述近端胃切除术后消化道重建的现状,探讨各种重建方法的优劣。

     

    Abstract: The incidence of gastric cancer in the upper third of the stomach, including early gastric cancer, is increasing in China, South Korea and Japan. Function-preserving surgery for early gastric cancer is mainly aimed at minimizing postoperative complications and improving postoperative quality of life. Proximal gastrectomy can resect the tumor while preserve part of the stomach tissue which is beneficial to improve the postoperative nutritional status and the postoperative quality of life. However, acid reflux, reflux and the subsequent reflux esophagitis after proximal gastrectomy due to the loss of the esophageal sphincter and His angle would affect postoperative quality of life. Clinical surgeons choose different methods of digestive tract reconstruction to improve the effect of anti-esophagogastric reflux. But there are many kinds of digestive tract reconstruction methods, which are controversial. The authors comprehensively analyze the related research progress at home and abroad, systematically elaborate the current status of digestive tract reconstruction after proximal gastrectomy, and discuss the advantages and disadvantages of various digestive tract reconstruction methods.

     

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