Option and evaluation of digestive tract reconstruction after proximal gastrectomy        HU Xiang. Department of General Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
Abstract    Proximal gastrectomy is most appropriate limited surgery for early cancer of the upper stomach. Under the condition of ensuring the radical resection, proximal gastrectomy can save more function of the stomach and get a better quality of life after surgery than distal gastrectomy. For the reason of the upper gastrectomy, the gastric cardia loss of function and the gastric volume changes leading to reflux esophagitis is the main reason for reducing postoperative quality of life. Proximal stomach reconstruction is varied according to the size of the residual stomach. The reconstruction should ensure the safety of the digestive tract anastomosis, prevent the reflux of gastrointestinal fluid, ensure food storage and emptying function, preserve the food physiological pathway,and facilitate the stomach, gallbladder, pancreas endoscopy. Several reconstructive procedures after proximal gastrectomy have been reported including esophagogastrostomy, jejunal interposition and jejunal pouch interposition. The esophagogastrostomy and jejunal interposition are the best choices for their simplicity. In contrast, jejunal pouch interposition is still in the research stage.