Abstract:

Choices and evaluation of digestive tract reconstruction for patients with gastrointestinal stromal tumor of esophagogastric junction        LIANG Han. Department of Gastric Cancer Surgery, Tianjin Medical University Cancer Institute & Hospital; National Clinical Research Center for Cancer, Tianjin 300060,China
Abstract    Local resection and proximal gastrectomy are the main choices for gastrointestinal stromal tumor which located in esophagogastric junction. The prerequisite for local resection is safety margin and preserving of the Zigzag line. The reconstruction after proximal gastrectomy includes esophagus-gastric tube anastomosis, among which patients with esophagogastric tube anterior wall anastomosis provides good effect to prevent reflux symptoms; Kamikawa procedure with double flap technique which is considered a promising approach to the prevention of reflux after esophagogastectomy; jejunal interposition maybe a good candidate for reconstruction and uncut interposition can simplify the procedure; double-tract reconstruction is a common procedure which can prevent postoperative anemia and vitamin B12 deficiency.

Key words: esophagogastric junction, gastrointestinal stromal tumor, digestive tract reconstruction

摘要：

食管胃结合部胃肠间质瘤的主要手术方式有局部切除和近端胃切除，在满足安全手术切缘的前提下，如果齿状线可以完整保留，即可以采取局部切除。近端胃切除术后的主要消化道重建方法有食管-管状残胃吻合，其中食管-管状残胃前壁吻合防反流效果更佳；Kamikawa双浆肌层瓣成型术操作复杂，但是防反流效果可靠；间置空肠重建方法可以有效地防止反流，连续间置空肠简化了手术操作，缩短了手术时间；双通路重建是近年比较常用的方法，可以有效预防术后贫血和维生素B12缺乏。

关键词: 食管胃结合部, 胃肠间质瘤, 消化道重建