三种消化道重建方式治疗胃癌合并2型糖尿病的研究进展

Advances in three digestive tract reconstruction methods for gastric cancer patients with DM2

目前胃癌合并2型糖尿病患者的手术治疗在国内外尚缺乏有效、规范的治疗方案.近几年国内外研究在不同的消化道重建方式治疗胃癌合并2型糖尿病患者的可能机制,疗效,术后并发症情况等方面有了新的发现.据此,我们对胃癌根治术后3种常见的消化道重建方式(毕Ⅰ、毕Ⅱ及Roux-en-Y吻合术)治疗胃癌合并2型糖尿病患者的可能机制,术后血糖控制效果,术后并发症情况等进行了探讨.结合当前研究结果,我们认为胃癌合并2型糖尿病的患者行胃癌根治性胃切除术,Roux-en-Y式吻合应为首选的消化道重建方式,其中以Roux-en-Y食管空肠端侧吻合为最佳术式.然现有的研究多为回顾性病例分析,缺乏临床随机对照研究的支持.因此,开展前瞻性临床随机对照研究以进一步验证上述3种重建方式治疗2型糖尿病的疗效,是我们今后努力的方向.

Until now, there is no efficient and standard surgery available for gastric cancer （GC） patients with type 2 diabetes mellitus （DM2）. In recent years, new progress has been achieved in research of three digestive tract reconstruction methods （BI, BII, and Roux-en-Y） after radical gastrectomy for GC patients with DM2 in terms of possible mechanisms, efficacy evaluation, and postoperative complications. Roux-en-Y should be the preferred reconstruction method for GC patients with DM2 who received radical gastrectomy, and esophagojejunal end-to-side （Roux-en-Y） anastomosis is the best choice. However, most of the existing studies are retrospective, and randomized controlled trials are lacking. To further assess the clinical efficiency of the three digestive tract reconstruction methods for GC patients with DM2, randomized controlled trials should be conducted in future.