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近端胃切除是针对上部胃的早期癌的手术,比远端胃切除能够保存更多的胃功能和获得更佳的生存质量。由于切除上部胃,贲门功能丧失、胃的容积变化等所致反流性食管炎是该术式降低术后生存质量的主要原因。重建的方式多种多样,残留胃的大小决定重建方式的选择。重建时应充分注意保证安全的消化道吻合,防止胃液、肠液的食管、胃的反流,保证食物的贮存和排空功能,保存生理性通路以及保障残胃、胆、胰的内镜检查的可行性。目前,近端胃切除术后消化道重建方式中仍以食管胃吻合和间置空肠法为主体,间置空肠贮袋仍处于研究阶段。
Proximal gastrectomy is an operation directed to the early stage of the upper stomach and can save more stomach function and obtain better quality of life than distal gastrectomy. Reflux esophagitis due to the removal of the upper stomach, loss of cardia function, changes in the volume of the stomach is the main reason for the surgery to reduce postoperative quality of life. The reconstruction of a variety of ways, the size of the residual stomach determines the choice of reconstruction methods. The reconstruction should pay full attention to ensure a safe gastrointestinal anastomosis, to prevent gastric juice, intestinal fluid esophagus, stomach reflux, to ensure the function of food storage and emptying, preservation of physiological access and to protect the residual stomach, bile, pancreatic endoscopy feasibility. At present, esophagogastric anastomosis and intercostal jejunal method are still the main part of gastrointestinal reconstruction after proximal gastrectomy, and the interstitial jejunal pouch is still in the research stage.