胃癌根治术后少见并发症的防治  

Diagnosis,prevention and treatment of post-operative rare complications after radical gastrectomy for gastric cancer

作　　者：刘宏达 王林俊[1] 徐泽宽[1] Liu Hongda;Wang Linjun;Xu Zekuan(Department of General Surgery,The First Affiliated Hospital,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院普通外科,南京210029

出　　处：《中华胃肠外科杂志》2023年第2期138-143,共6页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金(81871946、82072708);中国国家科学技术基础研究专项基金(2019FY101104);南京医科大学第一附属医院创新研究项目(PAPD);江苏省高等教育机构重点学科建设项目(JX10231801);江苏省重点学科(普通外科学)(ZDXKA2016005);南京医科大学部省共建肿瘤个体化医学协同创新中心。

摘　　要：胃癌根治术后并发症种类繁多,影响因素复杂,常见并发症的预防与诊治已有较多文献报道。然而,针对少见并发症防治的报道较少。胃癌根治术后少见并发症因其发生率低,常常不被重视。因此,临床医师对胃癌根治术后少见并发症的预防、诊断及治疗缺乏经验,亦缺少相关的指南和专家共识,这也给少见并发症的诊治和预防带来了困难。本文结合文献回顾及笔者的经验,就胃癌根治术后7种少见并发症(十二指肠残端瘘、胰瘘、乳糜漏、食管纵隔瘘、腹内疝、胃瘫、肠套叠)进行系统性阐述,以期为胃癌根治术后少见并发症的诊治和预防提供参考。Radical gastrectomy for gastric cancer results in various post-operative complications,and the influencing factors are complicated.The diagnosis,treatment and prevention of common complications have been reported in many literatures.However,there are few reports on the prevention and treatment of rare complications.Rare complications after radical gastrectomy are often overlooked due to their low incidence.In addition,there are few guidelines and expert consensus regarding to the rare complications.Therefore,clinicians may lack experience in the diagnosis,treatment and prevention of rare complications after radical gastrectomy.Based on the literature review and the author's experience,this article systematically reviews seven rare complications after radical gastrectomy(duodenal stump fistula,pancreatic fistula,chyle leakage,esophagomediastinal fistula,internal hernia,gastroparesis,and intussusception).This article aims to provide a comprehensive reference for the diagnosis,treatment and prevention of rare complications after radical gastrectomy for gastric cancer patients.

关 键 词：胃癌根治术 十二指肠残端瘘 胰瘘 乳糜漏 食管纵隔瘘 腹内疝 胃瘫 肠套叠 

分 类 号：R735.2[医药卫生—肿瘤]