全腹腔镜近端胃切除术的适应证及消化道重建方式的选择

Indications for total laparoscopic proximal gastrectomy and the following selection of gastrointestinal reconstruction methods

近年来,世界范围内胃上部癌发病率逐年升高,严重威胁人类健康。目前,根治性胃切除术仍然是胃上部癌的主要治疗方法,其主要术式为全胃切除术或近端胃切除术。近端胃切除术因其保留部分胃的功能,对患者营养状况影响较小而越来越受到关注。随着腹腔镜技术的进步,胃癌的腹腔镜治疗效果不断改善。近年来,全腹腔镜技术被应用于胃上部癌的治疗,但该手术方式在根治范围及消化道重建等问题上尚存争议。本文将重点介绍全腹腔镜近端胃切除术的适应证及如何合理地选择消化道重建的方式。

In recent years, the incidence of upper gastric cancer has increased annually worldwide. Upper gastric cancer has become a huge threat to human health. Until now, total and proximal gastrectomies are still the most commonly used surgeries for upper gastric cancer. More attention has been paid to proximal gastrectomy because it retains the function of the stomach and has little effect on nutrient absorption. Patients who received proximal gastrectomy achieved better nutritional status. With the development of laparoscopic techniques, laparoscopic radical gastrectomy has been largely performed in gastric cancer treatment. Total laparoscopic surgery has been applied in the treatment of upper gastric cancer in recent years. However, this surgical procedure is still controversial in terms of the range of radical treatment and reconstruction of the digestive tract. Combining our own experiences, we will focus on the indications of total laparoscopic proximal gastrectomy and the guidelines for choosing the most reasonable procedure for digestive tract reconstruction.