Zang Lu
Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Aug;15(8):787-9.
In recent years, laparoscopic gastrectomy for gastric cancer has boomingly developed in China. Surgical procedures include adequate surgical margin, radical lymphadenectomy and digestive tract reconstruction, while the latter is a key procedure for laparoscopic gastrectomy. Reconstruction procedures such as Billroth I, Billroth II and Roux-en-Y anastomosis are widely used in laparoscopy-assisted distal gastrectomy, while esophagojejunostomy by Roux-en-Y reconstruction is a reasonable option for laparoscopy-assisted total gastrectomy. Esophagogastrostomy is mainly used in laparoscopy-assisted proximal gastrectomy, and gastric tube reconstruction is an alternative procedure to decrease the gastroesophageal reflux. A small incision is usually used to facilitate the reconstruction, which has a less cost and easier manipulate, and is recommended in current China.
近年来,胃癌的腹腔镜胃切除术在中国蓬勃发展。手术操作包括足够的手术切缘、根治性淋巴结清扫和消化道重建,而后者是腹腔镜胃切除术的关键步骤。诸如毕罗Ⅰ式、毕罗Ⅱ式和Roux-en-Y吻合术等重建手术在腹腔镜辅助远端胃切除术中广泛应用,而Roux-en-Y重建的食管空肠吻合术是腹腔镜辅助全胃切除术的合理选择。食管胃吻合术主要用于腹腔镜辅助近端胃切除术,胃管重建是减少胃食管反流的替代手术。通常采用小切口以利于重建,其成本较低且操作更简便,目前在中国受到推荐。