早期Siewert Ⅱ/Ⅲ型食管胃结合部腺癌不同消化道重建方式术后生活质量的研究进展与争议

Research progress and controversy of early stage Siewert typeⅡ/Ⅲesophagogastric junction adenocarcinoma with different digestive tract reconstruction methods for postoperative quality of life

近年来,食管胃结合部腺癌(AEG)的发病率逐渐升高。目前,根治性手术仍是早期AEG最有效的治疗方法,其手术方式包括近端胃切除术和全胃切除术。近端胃切除术虽然保留了胃的部分结构与功能,但由于术后胃食管反流等并发症严重影响患者术后生活质量。而全胃切除术虽然降低了胃食管反流等并发症的发生率,但手术创伤大,且术后消化功能严重减退,导致贫血等并发症的发生。由于早期胃癌预后良好,因此如何选择消化道重建方式,提高患者的术后生活质量逐渐成为外科医师关注的重点。现为早期食管胃结合部腺癌不同消化道重建方式的术后生活质量作一综述。

In recent years,the incidence of esophagogastric junction adenocarcinoma(AEG)has gradually increased.At present,radical surgery is still the most effective treatment for early AEG,and its surgical methods include proximal gastrectomy and total gastrectomy.Although proximal gastrectomy preserves part of the structure and function of the stomach,postoperative complications such as gastroesophageal reflux seriously affect the quality of life of patients.Although total gastrectomy reduces the incidence of complications such as gastroesophageal reflux,the surgical trauma is large,and the postoperative digestive function is severely reduced,leading to complications such as anemia.As the prognosis of early gastric cancer is good,how to choose the gastrointestinal reconstruction method and improve the patient′s postoperative quality of life has gradually become the focus of the surgeon′s attention.The postoperative quality of life of different digestive tract reconstruction methods for early esophagogastric junction adenocarcinoma is reviewed.