近端胃切除消化道重建中国专家共识(2024版)  

Chinese consensus on digestive tract reconstruction after proximal gastrectomy(2024 edition)

作　　者：中国抗癌协会胃癌专业委员会 徐泽宽[2] 梁寒[3] 李子禹 胡文庆[5] 王林俊 徐皓[2] 崔鹏 Chinese Gastric Cancer Association;Xu Zekuan;Liang Han;Li Ziyu;Hu Wenqing

机构地区：[1]不详 [2]南京医科大学第一附属医院 [3]天津市肿瘤医院 [4]北京大学肿瘤医院 [5]长治医学院附属长治市人民医院

出　　处：《中华胃肠外科杂志》2024年第10期983-995,共13页Chinese Journal of Gastrointestinal Surgery

摘　　要：食管胃结合部腺癌的发病率近年来逐渐升高。近端胃切除术因切除范围较小、保留部分胃功能、安全性高和术后营养状况好以及对患者心理负面影响小,临床应用显著增多。近端胃切除术破坏了食管胃结合部的正常解剖结构,术后贲门抗反流功能永久丧失,同时保留的幽门可能会导致胃排空延迟,易并发反流性食管炎和吻合口狭窄等并发症。近年来,各种抗反流消化道重建方式应运而生,使近端胃切除术既可以部分保留胃的功能,又能避免术后出现严重的反流性食管炎。本共识在《近端胃切除消化道重建中国专家共识(2020版)》基础上,更新多种抗反流术式的研究结果,旨在推广各种近端胃切除消化道重建术式的技术要点,评价其抗反流功效和优缺点,为临床上开展近端胃切除消化道重建提供指导。The incidence of adenocarcinoma of the esophagogastric junction has been gradually increasing in recent years.Due to the smaller resection range,partial preservation of the function of stomach,high safety,better postoperative nutritional status,and lesser negative psychological impact on patients,the application of proximal gastrectomy has increased significantly.Proximal gastrectomy disrupts the normal anatomical structure of the esophagogastric junction,resulting in permanent loss of the anti-reflux function of the cardia.At the same time,the retained pylorus may lead to delayed gastric emptying,making it prone to the complications such as reflux esophagitis and anastomotic stenosis.In recent years,various anti-reflux digestive tract reconstruction methods have emerged,allowing proximal gastrectomy to partially preserve stomach function while avoiding severe postoperative reflux esophagitis.This consensus,based on the"Chinese consensus on digestive tract reconstruction after proximal gastrectomy(Version 2020)",updates the research findings of multiple anti-reflux surgical techniques.It aims to promote the technical points of various proximal gastrectomy digestive tract reconstruction techniques,evaluate their anti-reflux efficacy,and provide guidance for the clinical application of digestive tract reconstruction after proximal gastrectomy.

关 键 词：胃肿瘤 近端胃切除术 消化道重建 反流性食管炎 

分 类 号：R735[医药卫生—肿瘤]