虽然上消化道重建方式多种多样，但目前尚无被公认的最佳重建方式。上消化道重建后，一方面必须控制好并发症的发生率；另一方面要保证病人有满意的营养状态和良好的生存质量。胃癌根治术后的重建方式也是专家们一直讨论和研究的热点，一直受到大家的重视。全胃切除术后，Roux-en-Y吻合是一种简单、并发症少，又能满足功能要求的重建方式。对病期晚、预后差的进展期胃癌病人，Roux-en-Y吻合时不建议附加贮袋，对于良性肿瘤或者早期胃癌，可以附加重建贮袋，以期提高生存质量。远端胃大部切除术后，相对于Billroth Ⅰ式吻合来说，Billroth Ⅱ式或Roux-en-Y吻合重建术并发症少、肿瘤复发率低。Billroth Ⅰ式吻合重建的适用范围较为有限。近端胃大部切除术后，采用食管残胃(管状胃)吻合是较为常见的重建方式。幽门重建的作用还存在一定争议，有待进一步研究。

Upper digestive tract reconstruction methods: reasonable option and evaluation        JI Jia-fu, JI Xin. Department of Gastrointestinal Tumor Surgery, Beijing Cancer Hospital, Peking University Cancer Hospital, Beijing 100142, China
Corresponding author: JI Jia-fu, E-mail: jiafuj@hotmail.com
Abstract    Several reconstruction techniques are possible after gastrectomy. But the best reconstruction technique hasn’t been admitted yet by now. The best reconstruction should meet the condition of maintaining satisfactory nutritional status and quality of life meanwhile keeping postoperative morbidity as low as possible. After total gastrectomy, Roux-en-Y reconstruction remains the easiest solution with satisfactory functional results and less complication. A pouch reservoir is suggested to make for patients with benign tumor and early gastric cancer, not for  patients with advanced tumor and poor prognosis, during Roux-en-Y reconstruction. After distal gastrectomy, Billroth Ⅱ or Roux-en-Y reconstruction should be preferred over Billroth I reconstruction because of lower postoperative morbidity and better oncologic margins. After proximal gastrectomy, esophagogastric anastomosis is the basic reconstruction method. Gastric remnant is made into gastric tube in the operation. The effect of pyloroplasty remains controversial. The further study is needed to improve the quality of life after operation.