Digestive tract reconstruction after laparoscopic proximal gastrectomy for adenocarcinoma of esophagogastric junction.
10.3760/cma.j.cn441530-20211123-0473
- VernacularTitle:食管胃结合部腺癌腹腔镜近端胃切除后消化道重建方式选择策略
- Author:
Jun Jun MA
1
;
Zi Rui HE
1
;
Lu ZANG
1
Author Information
1. Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine/Shanghai Clinical Medical Center for Minimally Invasive Surgery, Shanghai 200025, China.
- Publication Type:Multicenter Study
- Keywords:
Adenocarcinoma of the esophagogastric junction;
Digestive tract reconstruction;
Laparoscopic surgery;
Proximal gastrectomy
- MeSH:
Adenocarcinoma/surgery*;
Esophageal Neoplasms/surgery*;
Esophagogastric Junction/surgery*;
Gastrectomy/methods*;
Humans;
Laparoscopy;
Quality of Life;
Retrospective Studies;
Stomach Neoplasms/surgery*
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(2):124-130
- CountryChina
- Language:Chinese
-
Abstract:
The incidence of adenocarcinoma of esophagogastric junction (AEG) is increasing in recent years. Its diagnosis, lymph node metastasis and digestive tract reconstruction are all different from those of upper gastric cancer. With the development of the concept of function preserving surgery for gastric cancer, the clinical application of laparoscopic proximal gastrectomy in AEG is increasing. In this kind of operation, in addition to ensuring sufficient radical cure of tumor, the short-term smooth recovery and long-term quality of life of patients are also important. The reconstruction of digestive tract after proximal stomach operation is of great significance. According to the author's own practical experience, in clinical work, the author selects different surgical resection scope and digestive tract reconstruction methods according to Siewert classification of AEG. For Siewert Ⅱ AEG, laparoscopic PG is mostly used, and laparoscopic esophageal tubular gastric side-to-side anastomosis or double channel anastomosis is mostly used for digestive tract reconstruction. It is believed that with the emergence of long-term follow-up results and the development of multicenter randomized controlled research, some controversial questions will be better answered. We should pay attention to the individual differences of patients. For different individuals, combined with the operator's experience, on the basis of ensuring the radical cure of tumor, we should adopt appropriate surgical resection scope and digestive tract reconstruction, so as to bring better long-term quality of life for patients.
