腹腔镜近端胃切除术后消化道重建方式及食管胃双肌瓣吻合应用前景

Digestive tract reconstruction after laparoscopic proximal gastrectomy and the application prospect of esophagogastric anastomosis with double flap technique

胃上部早期癌可选择行腹腔镜近端胃切除术(LPG),但术后发生胃食管反流会严重影响患者生命质量。食管胃双肌瓣吻合是利用食管与胃前壁吻合的一种消化道重建方式,与其他消化道重建方式比较,其能较好维持患者术后体质量,改善患者营养状况,提高远期生命质量,且具有良好的抗反流效果,并保留患者术后行内镜检查和治疗的可能性。笔者回溯国内外文献,结合临床实践,阐述LPG现状及其消化道重建方式,深入探讨食管胃双肌瓣吻合的应用前景。

Laparoscopic proximal gastrectomy(LPG)can be selected for the treatment of early upper gastric carcinoma,but gastroesophageal reflux after operation would seriously affect the quality of life of patients.Esophagogastric anastomosis with double flap technique is a digestive tract reconstruction method using the anastomosis between the esophagus and the anterior wall of the stomach.Compared with other digestive tract reconstruction methods,esophagogastric anastomosis with double flap technique can maintain the postoperative body mass of patients in good condition,improve the nutritional status and the lon-term quality of life of patients.Esophagogastric anastomosis with double flap technique has good anti reflux effects and retain the possibility of endoscopic examination and treatment.By reviewing literatures at home and abroad,and combined with clinical experiences,the authors discuss current status and digestive tract reconstruction methods of LPG,and deeply investigate the application prospect of esophagogastric anastomosis with double flap technique.