胃癌根治术后吻合口相关并发症的发生原因及防治要点

Prevention and treatment of anastomosis complications after radical gastrectomy

胃癌根治术后吻合口相关并发症主要包括吻合口瘘、吻合口出血及吻合口狭窄。临床上吻合口相关并发症并不少见，且仍是引起胃癌患者围手术期死亡的最常见的外科并发症。规范化的培训能使术者充分认识到严格的手术适应证、充分的术前评估准备、规范的外科操作是预防胃癌根治术后吻合口相关并发症的基本措施。及早识别这些并发症，并根据不同的临床背景积极采取有效的治疗措施，是治疗吻合口相关并发症、缩短治疗周期、降低病死率的关键。

The anastomotic complications following radical gastrectomy mainly include anastomotic leakage, anastomotic hemorrhage, and anastomotic stricture. Theanastomotic complications are not rare and remain the most common complications resulting in the perioperativedeath of patients with gastric cancer. Standardized training could let surgeons fully realize that strict selection of operative indications, thorough preoperative assessment and preparation, and refined operation in surgery are the essential measures to prevent the anastomotic complications following radical gastrectomy. In addition, identifying these complications timely and taking effective measures promptly according to the clinical context are the keys to treating these complications, reducing the treatment cycle, and decreasing the mortality.