[近辺胃切除術後の消化管の再建 - 現在の応用と食道胃切除術の将来の展望]
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1Northern Jiangsu People's Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou 225001, China Northern Jiangsu People's Hospital, Yangzhou 225001, China General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou 225001, China Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou 225001, China.
まとめ
近親胃切除術 (PG) は機能的な保存を提供しますが,反流や収縮を予防する上で課題に直面しています. このレビューでは,再建技術を胃の改造と心臓の再建に分類し,結果を改善します.
科学分野:
- 胃腸内科 胃腸内科
- 外科腫瘍学外科腫瘍学
- 外科技術革新は,外科技術革新である.
背景:
- 近接性胃切除術 (PG) は,胃機能の保存と生活の質の向上のために注目を集めています.
- PG後の反流およびアナストモティック収縮の効果的な予防は,重要な外科的課題であり続けています.
研究 の 目的:
- 近親胃切除術後の胃食道アナストモシス技法をレビューし,分類する.
- 機能的な結果のための異なる再構築的アプローチの利点と限界を分析する.
主な方法:
- 再建的な概念を"残留胃再形成"と"心臓再建"のアプローチに分類する.
- 管状胃食道アナストモシス (TGA),横断扇形ダム,GIRAFFE再構築,ダブルフラップ技術 (DFT),シングルフラップ技術 (SFT),トンネル法を含む代表的なテクニックの要約.
主要な成果:
- 残留胃改造技術は,残留胃の形状 (TGA,GIRAFFEなど) を変化させます.
- 心臓の再建技術は,フラップ (例えば,DFT,SFT,トンネル法) を使用して反流弁を作成します.
- DFTは,実質的な証拠を持っている; SFTは,よりシンプルな操作と狭窄のリスクを低減します; トンネル方法は,有効性と供給のバランスをとります.
結論:
- 将来の進歩は",残留胃再形成"と"心臓再構築"の概念を統合することにある.
- ロボットと最小侵襲的技術は,正確で標準化された機能的なPG再構築に不可欠です.
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