中国实用外科杂志2025，Vol.45Issue(2)：195-201,7.DOI:10.19538/j.cjps.issn1005-2208.2025.02.12
Siewert Ⅱ/Ⅲ型食管胃结合部腺癌行近端胃切除术SOFY重建与全胃切除术Roux-en-Y重建安全性、疗效及营养水平对比研究
Study on safety,efficacy and nutrition of proximal gastrectomy with SOFY versus total gastrectomy with Roux-en-Y for treating Siewert Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction
摘要
Abstract
Objective To compare the safety,efficacy and nutrition of proximal gastrectomy(PG)with SOFY versus total gastrectomy(TG)with Roux-en-Y for treating Siewert Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction(AEG).Methods We used a bidirectional cohort study to analyze the clinical data of 154 Siewert Ⅱ/Ⅲ AEG patients treated at Beijing Friendship Hospital,Capital Medical University from March 2017 to June 2023.There were 66 cases in PG group and 88 cases in TG group.The main outcome was weight loss rate 1 year after surgery in both groups.Results The PG group showed significant advantages over the TG group in average operative time,intraoperative blood loss,time to pass gas,and time to liquid intake,with statistically significant differences(P＜0.05).Among the 119 cases that completed a one-year follow-up,there were 53 in the PG group and 66 in the TG group.The weight loss rates at 6 months(-10.6％vs.-14.0％)and at 1 year(-9.0％vs.-15.2％)were lower in the PG group compared to the TG group,with statistically significant differences(P＜0.05).The PG group had better outcomes regarding diarrhea and the degree of eating restriction at 1 year after surgery compared to the TG group.However,the TG group had a lower incidence of gastroesophageal reflux(9.1％vs.50.9％),better reflux symptom scores,and better overall health status at 1 year after surgery than the PG group,with statistically significant differences(P＜0.05).In the PG group,21 patients(39.6％)developed reflux esophagitis at 1 year after surgery,classified according to the Los Angeles classification(LA),13 cases at LA-A(61.9％),6 cases at LA-B(28.6％),and 2 cases at LA-C(9.5％),with no cases at LA-D.Conclusion In the surgical treatment of Siewert Ⅱ/Ⅲ AEG,PG(SOFY reconstruction)shows significant advantages over TG(Roux-en-Y reconstruction)in terms of surgical operation,perioperative recovery,and postoperative weight maintenance.However,TG has a notable advantage in postoperative quality of life.Additionally,the incidence of reflux esophagitis is higher after SOFY reconstruction,but most cases are classified as LA-A,and symptoms can be controlled with standard doses of PPI medication.关键词
食管胃结合部腺癌/近端胃切除术/全胃切除术/消化道重建/生活质量Key words
adenocarcinoma of the esophagogastric junction/proximal gastrectomy/total gastrectomy/digestive tract reconstruction/quality of life分类
医药卫生引用本文复制引用
张海翘,张军,王鈢,黄勇,王子萌,李佳璇,薛雅圣,郑智,刘小野,尹杰..Siewert Ⅱ/Ⅲ型食管胃结合部腺癌行近端胃切除术SOFY重建与全胃切除术Roux-en-Y重建安全性、疗效及营养水平对比研究[J].中国实用外科杂志,2025,45(2):195-201,7.基金项目
国家自然科学基金项目(No.82300646) （No.82300646）
北京市属医院科研培育项目(No.PX20240103,No.PX2020001) （No.PX20240103,No.PX2020001）
北京市自然科学基金项目(No.7232334) （No.7232334）
首都卫生发展科研专项项目(No.2024-2-2028) National Natural Science Foundation of China(No.82300646) （No.2024-2-2028）
Beijing Municipal Administration of Hospitals Incubating Program(No.PX20240103,No.PX2020001) （No.PX20240103,No.PX2020001）
Beijing Natural Science Foundation(No.7232334) （No.7232334）
Capital's Funds for Health Improvement and Research(No.2024-2-2028) （No.2024-2-2028）
