Quality control of digestive tract reconstruction after proximal gastrectomy
徐泽宽 1王林俊 1李沣员 1葛晗 1卜建红
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作者信息
1. 南京医科大学第一附属医院普通外科，南京 210029
折叠
摘要
随着食管胃结合部癌发病率的增高，近端胃切除术的应用率逐年上升。近端胃切除后消化道重建的方式种类繁多，部分重建方式问世时间尚短，存在术者临床经验较少、重建方式欠规范的情况。此状况势必会带来近端胃切除消化道重建后临床疗效参差不齐的后果。为促进近端胃切除消化道重建的规范化实施，从而提高近端胃切除术的临床疗效，降低术后并发症发生率，本文针对在《近端胃切除消化道重建中国专家共识（2020版）》中专家推荐率最高的双通道吻合、食管管型胃吻合、食管残胃侧壁吻合（side overlap）和双肌瓣吻合（double flaps）4种消化道重建方式，从适应证选择、手术步骤及技术要点分别进行阐述，以期为施行近端胃切除消化道重建的质量化控制提供参考。 With the increasing incidence of esophagogastric junction carcinoma, the application rate of proximal gastrectomy has been rising annually. There is a wide variety of methods for digestive tract reconstruction after proximal gastrectomy, and some of these reconstruction methods have been introduced relatively recently, with limited clinical experience, which led to a lack of standardization. Such a situation will inevitably result in inconsistent clinical outcomes of proximal gastrectomy with digestive tract reconstruction. To promote the standardization of digestive tract reconstruction after proximal gastrectomy, improve the clinical efficacy of proximal gastrectomy, and reduce the occurrence of postoperative complications, this article elaborates on the indications, surgical steps and technical points of the four methods after proximal gastrectomy recommended by the "Chinese consensus on digestive tract reconstruction after proximal gastrectomy (2020 edition)", such as double tract, side overlap, double flaps and gastric tube reconstruction, providing guidance for the application of digestive tract reconstruction after proximal gastrectomy.
Abstract
With the increasing incidence of esophagogastric junction carcinoma, the application rate of proximal gastrectomy has been rising annually. There is a wide variety of methods for digestive tract reconstruction after proximal gastrectomy, and some of these reconstruction methods have been introduced relatively recently, with limited clinical experience, which led to a lack of standardization. Such a situation will inevitably result in inconsistent clinical outcomes of proximal gastrectomy with digestive tract reconstruction. To promote the standardization of digestive tract reconstruction after proximal gastrectomy, improve the clinical efficacy of proximal gastrectomy, and reduce the occurrence of postoperative complications, this article elaborates on the indications, surgical steps and technical points of the four methods after proximal gastrectomy recommended by the "Chinese consensus on digestive tract reconstruction after proximal gastrectomy (2020 edition)", such as double tract, side overlap, double flaps and gastric tube reconstruction, providing guidance for the application of digestive tract reconstruction after proximal gastrectomy.
关键词
胃肿瘤/近端胃切除/消化道重建/质量化控制
Key words
Stomach neoplasms/Proximal gastrectomy/Digestive tract reconstruction/Quality control
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