Abstract: Controversy and consensus on digestive tract reconstruction after proximal gastrectomy for early gastric cancer        WANG Lin-jun, LI Zheng, XU Ze-kuan. Department of General Surgery, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
Corresponding author: XU Ze-kuan, E-mail: xuzekuan@njmu.edu.cn
Abstract    Proximal gastrectomy belongs to the category of function-preserving gastrectomy. In recent years, with the popularization of the concept of " stomach-preserving and function-preserving ", its application in the surgical diagnosis and treatment of early gastric cancer has gradually increased. Compared with total gastrectomy, proximal gastrectomy has the advantages of improving the postoperative nutritional status of patients and so on. However, because proximal gastrectomy destroys the original anti-reflux structure of the cardia, patients experience different degrees of reflux esophagitis symptoms after operations. Based on ensuring the radical resection of the tumor, how to minimize the occurrence of reflux esophagitis and improve the postoperative quality of life of patients is the ideal goal to be achieved of proximal gastrectomy.

Key words: early gastric cancer, laparoscopy, proximal gastrectomy, digestive tract reconstruction, anti-reflux

摘要： 近端胃切除术是一种保留功能的胃切除手术，近年来在早期胃癌的外科诊疗中的应用逐渐增多。近端胃切除术相较于全胃切除术具有能改善病人术后营养状况等优点，但是由于其破坏了原有的贲门抗反流结构，病人术后出现不同程度的反流性食管炎症状。对于近端胃切除术消化道重建方式的选择，目前尚缺乏公认的理想方法。临床较常用的重建方式包括食管残胃吻合、间置空肠吻合及双通道吻合。同时，各种改良或新型消化道重建方式也在临床应用中不断涌现。各种近端胃切除术消化道重建方式各有利弊，需要开展更多的临床研究进行论证。

关键词: 早期胃癌, 腹腔镜, 近端胃切除, 消化道重建, 抗反流