Li Li, Wang Lei, Yang Jia-Li, Wang Hui-Ju, Wang Yuan-Yu
General Surgery, Cancer Center, Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang 310014, China.
Key Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
J Cancer. 2023 Jul 15;14(11):2161-2172. doi: 10.7150/jca.83909. eCollection 2023.
Proximal gastrectomy is more frequently recommended for early upper gastric cancer and Siewert II gastroesophageal junction cancer less than 4 cm in length. After proximal gastrectomy, the anatomical structure of the gastroesophageal junction can be destroyed, and the anti-reflux effect of the cardia is lost. In recent years, as various anti-reflux reconstructions have been developed, some functions of the stomach are retained, and serious reflux esophagitis is avoided after proximal gastrectomy. In this article, we summarized the indications, advantages, and disadvantages of various classic reconstruction and latest improved reconstruction method including esophageal and residual stomach anastomosis, tubular gastroesophageal anastomosis, muscle flap anastomosis, jejunal interposition, and double-tract reconstruction.
近端胃切除术更常用于早期胃上部癌和长度小于4 cm的Siewert II型胃食管交界癌。近端胃切除术后，胃食管交界的解剖结构可能被破坏，贲门的抗反流作用丧失。近年来，随着各种抗反流重建方法的发展，近端胃切除术后保留了部分胃功能，避免了严重的反流性食管炎。在本文中，我们总结了各种经典重建方法和最新改良重建方法的适应证、优缺点，包括食管与残胃吻合、管状胃食管吻合、肌瓣吻合、空肠间置和双通道重建。
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