·综述.388JSurgConceptsPract2023,Vol.28,No.4近端胃切除抗反流消化道重建方式的研究进展孙强，姚骏，张鑫，杜杉珊²综述，王伟军1审校（1.海军军医大学附属长征医院胃肠外科，上海200003;2.上海市闵行区古美社区卫生服务中心针伤科，上海201100)[摘要]近端胃癌在中国及部分亚洲国家的发病率呈逐年上升趋势。手术是该疾病最有效、最常用的治疗方式。传统全胃切除术具有较好的根治效果，但术后难以避免营养代谢障碍、生活质量下降等并发症发生。近年来临床开展的近端胃切除术在切除肿瘤组织的同时，保留部分胃组织，有利于改善病人术后营养状况。然而近端胃切除术中破坏食管括约肌和His角，引起残胃反酸、反流，导致反流性食管炎,同样也影响病人的生活质量。为解决反流的问题，临床医师探索不同消化道重建术式，目前有报道的消化道重建方法很多，各有优劣。本文结合相关文献和临床新进展，列举目前常用消化道重建方法，总结其术后生活质量、生存结局相关文献资料，以供临床医师参考和选择。关键词：近端胃癌；近端胃切除术；反流性食管炎；消化道重建中图分类号：R735.2;R571文献标志码：C文章编号：1007-9610(2023)04-0388-06D01:10.16139/j.1007-9610.2023.04.017ResearchprogressofantirefluxdigestivetractreconstructionforproximalgastrectomySUNQiang',YAOJun',ZHANGXin',DUShanshan',WANGWeijun'1.DepartmentofGastrointestinalSurgery,ChangzhengHospital,NavalMilitaryMedicalUniversity,Shanghai200003,China;2.DepartmentofAcupunctureandTraumatology,GumeiCommunityHealthServiceCenterofMinhangDistrict,Shanghai201100,China[Abstract]TheincidencerateofproximalgastriccancerinChinaandsomeAsiancountriesisincreasingyearbyyear.Surgeryisthemosteffectiveandcommonlyusedtreatmentforproximalgastriccancer.Traditionaltotalgastrectomyhasagoodcurativeeffect,butitscomplications,suchasdystrophicmetabolismanddecreasedqualityoflife,limiteditsuse.Inrecentyears,theproximalgastrectomycarriedoutclinicallycanremovetumortissueandpreservepartofgastrictis-sue,whichisconducivetoimprovingthepostoperativenutritionalstatusofpatients.However,duringproximalgastrectomy,theesophagealsphincterandHisangleweredamaged,resultinginresidualgastricacidrefluxandgastroesophagealreflux,resultinginrefluxesophagiti...
