全腹腔镜胃癌根治术消化道重建方法选择与评价

Selection and appraisal of digestive tract reconstruction after totally laparoscopic gastrectomy for gastric cancer

近年来，随着腹腔镜技术的发展．全腹腔镜胃癌根治术的临床应用越来越广泛。消化道重建是腹腔镜胃癌手术的技术难点之一，关系到患者术后的生活质量。消化道重建方式各具特点．如何选择合适的消化道重建方式，目前尚未达成统一的共识。本文结合文献和笔者临床实践的体会。阐述并评价全腹腔镜远端胃切除、全胃切除和近端胃切除各种消化道重建方式。以期在肿瘤根治的前提下选择合理的消化道重建方式、降低患者术后并发症发生率、提高术后生活质量、切实从全腹腔镜手术中获益。

In recent years, with the developmem of laparoscopic technology, more and more totally laparoscopic gastrectomy has been applied. The reconstruction of digestive tract is the key procedure of laparoscopic gastrectomy and is associated with the postoperative quality of life. Each method of digestive tract reconstruction has its own characteristic, however, unified consensus on how to choose the optimal method for digestive tract reconstruction has not yet been reached till today. In this article, we will discuss and evaluate the advantages, disadvantages and indications of these reconstruction methods after totally laparoscopic distal gastrectomy, total gastrectomy and proximal gastrectomy combined with relative literatures and our practical experience in order to provide the reference to choose the reasonable reconstruction method at the premise of radical resection, which may decrease the morbidity of postoperative complication, increase the quality of life, and bring benefits to patients definitely.