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[部分及全胃切除术后的重建技术]

[Reconstruction techniques after partial and total gastric resection].

作者信息

Gutschow Christian A, Gebauer Florian, Schneider Marcel A, Schröder Wolfgang

机构信息

Departement für Viszeral- und Transplantationschirurgie, Universitätsspital Zürich, Zürich, Schweiz.

Klinik für Allgemein‑, Viszeral- und onkologische Chirurgie, Helios Universitätsklinik Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Deutschland.

出版信息

Chirurgie (Heidelb). 2025 Jul 11. doi: 10.1007/s00104-025-02347-3.

Abstract

The domains of gastric surgery are nowadays oncological resections, often as part of multimodal treatment concepts. Depending on the extent of the gastric resection as total, proximal or distal (or subtotal) gastrectomy, different methods of reconstruction are available. These reconstruction procedures have not basically changed with the implementation of minimally invasive or robotic techniques but the spectrum of possible anastomotic techniques has been substantially expanded. Functional, in particular nutritional disorders with subsequent impairment of the postoperative health-related quality of life, are often observed after gastric resection. After surgical resection these disorders principally occur less frequently with partial preservation of a gastric residue. After (total) gastrectomy, the placement of a jejunal pouch significantly reduces the incidence of postoperative dumping symptoms. Following proximal gastrectomy, double-tract reconstruction provides certain functional advantages as compared to the Roux‑en-Y.

摘要

如今,胃外科手术的领域主要是肿瘤切除,通常是多模式治疗理念的一部分。根据胃切除的范围,如全胃、近端或远端(或次全)胃切除术,有不同的重建方法。随着微创或机器人技术的应用,这些重建手术在本质上并没有改变,但可能的吻合技术范围已大幅扩大。胃切除术后常观察到功能障碍,尤其是营养紊乱,随后会损害术后与健康相关的生活质量。手术切除后,部分保留胃残端时,这些紊乱主要发生的频率较低。(全)胃切除术后,空肠袋的放置显著降低了术后倾倒综合征的发生率。近端胃切除术后,与Roux-en-Y术式相比,双通路重建具有一定的功能优势。

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