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近端胃大部切除仅适于T1N0期食管胃结合部腺癌(AEG),近端胃大部切除后食管-残胃吻合是最常用的术式,但是由于破坏了防反流结构,造成残胃内容物反流至食管内导致反流性食管炎。食管-残胃前壁吻合可以在残胃残端形成类似胃底结构,形成HIS角,防反流作用明显。采取食管与胃黏膜单层套入式吻合也可以达到防止反流的效果。管状胃基本保持了胃的解剖结构,具备食物的贮存与消化功能。间置空肠可以有效防止反流,空肠储袋间置增加了残胃容量。双通路加近口端储袋可以延缓食物进入十二指肠的时间。
Subtotal gastrectomy is only suitable for T1N0 esophagogastric junction adenocarcinoma (AEG), esophagogastrostomy after proximal gastrectomy is the most commonly used surgical procedures, but due to the destruction of the anti-reflux structure, resulting in Residual gastric contents reflux into the esophagus lead to reflux esophagitis. Esophageal-gastric anastomosis anastomosis stump can be formed in the residual gastric fundus similar to the formation of HIS angle, anti-reflux effect significantly. Esophageal and gastric mucosa to take a single set of anastomosis can also be achieved to prevent the effect of reflux. Tubular stomach to maintain the basic anatomy of the stomach, with food storage and digestion. Intermittent jejunum can effectively prevent reflux, increased storage of jejunal pouch gastric residual capacity. Two-way near the mouth pocket can delay food into the duodenum time.