Current status and trends of anti-reflux digestive tract reconstruction methods after proximal gastrectomy
10.3760/cma.j.cn115610-20200731-00523
- VernacularTitle:近端胃切除术抗反流消化道重建方式的现状与趋势
- Author:
Fenglin LIU
1
;
Peng ZHOU
Author Information
1. 复旦大学附属中山医院普通外科，上海 200032
- From:
Chinese Journal of Digestive Surgery
2020;19(9):951-956
- CountryChina
- Language:Chinese
-
Abstract:
Proximal gastrectomy, the surgical treatment of gastric upper adenocarcinoma or early esophagogastric junction adenocarcinoma, has received more and more attention. However, pathophysiological changes after proximal gastrectomy lead to a high risk of severe gastroesophageal reflux or reflux esophagitis, such as loss of mechanical anti-regurgitation barrier and receptive relaxation, decrease of peristalsis of remnant, incoordinate contraction, pylorus spasm, which limit its widespread use. Dozens of digestive tract reconstruction methods with different anti-reflux design have been reported in recent years. These strategies could be divided into 3 categories: buffer zone method, reconstruction of mechanical anti-regurgitation barrier, speeding up gastric emptying. The authors analyze the pathophysiological changes related with gastroesophageal reflux after proximal gastrectomy from the perspective of anatomy and phy-siology, summarize the advantages and disadvantages of anti-regurgitation methods, and look forward to the development trends in the future.
