食管胃结合部腺癌全胃切除食管空肠吻合口瘘临床管理进展

Progress in Clinical Management of Esophago-Jejunal Anastomotic Fistula with Total Gastrectomy for Adenocarcinoma of the Esophagogastric Junction

食管胃结合部腺癌近年来发病率呈上升趋势,食管空肠吻合口瘘是Siewert III型和部分Siewert II型食管胃结合部腺癌行全胃切除术后严重并发症之一,严重危及公众健康。目前食管空肠吻合口瘘治疗主要以保守治疗为主,并辅以内镜治疗,手术治疗等治疗方式,但治疗效果不尽相同,最佳治疗方案仍存争议。文章旨在综述食管空肠吻合口瘘治疗现状及进展,进一步完善全胃切除术后并发症的处理,改善预后,提高患者生存质量,为临床策略提供参考。

The incidence of adenocarcinoma of the esophagogastric junction has been on the rise in recent years. Esophago-jejunal anastomotic fistula is one of the serious complications after total gastrec-tomy for Siewert III and some Siewert II adenocarcinomas, which seriously endangers public health. Currently, the treatment of esophagojejunostomy fistula is mainly based on conservative treatment, supplemented by endoscopic treatment, surgical treatment and other therapeutic modalities. However, the treatment effects vary, and the optimal treatment plan remains controversial. The aim of this article is to review the current status and progress of esophagojejunostomy fistula treatment, further improve the management of complications after total gastrectomy, improve the prognosis, improve the quality of survival of patients, and provide reference for clinical strategies.