spracticeХирургическая практикаSurgical practice (Russia)2223-2427АНО "Консорциум "Медицинская техника"10.38181/2223-2427-2023-1-6spractice-388Research ArticleОНКОЛОГИЯONCOLOGYСпособы реконструкции после проксимальной резекции желудка по поводу ракаReconstruction methods after proximal gastrectomy for cancerhttps://orcid.org/0000-0002-3904-6415КомаровР. Н.KomarovR. N.

Комаров Роман Николаевич - доктор медицинских наук, профессор, заведующий кафедрой факультетской хирургии № 1.

119435, Москва, ул. Большая Пироговская, 6, стр. 1

Roman N. Komarov - Head of the Department of Faculty Surgery № 1, Sechenov First Moscow State Medical University.

Bolshaya Pirogovskaya St. 6, building 1, Moscow, 119435

komarovroman@rambler.ruhttps://orcid.org/0000-0002-9950-6575ОсмининС. В.OsmininS. V.

Осминин Сергей Викторович - кандидат медицинских наук, доцент кафедры факультетской хирургии № 1.

119435, Москва, ул. Большая Пироговская, 6, стр. 1

Sergey V. Osminin - Associate professor, Department of Faculty Surgery № 1, Sechenov First Moscow State Medical University.

Bolshaya Pirogovskaya St. 6, building 1, Moscow, 119435

dr.osminin@gmail.comhttps://orcid.org/0000-0001-9101-9484НовиковС. С.NovikovS. S.

Новиков Сергей Сергеевич - ассистент кафедры факультетской хирургии № 1.

119435, Москва, ул. Большая Пироговская, 6, стр. 1

Sergey S. Novikov - Assistant professor, Department of Faculty Surgery № 1, Sechenov First Moscow State Medical University.

Bolshaya Pirogovskaya St. 6, building 1, Moscow, 119435

dr.ssnovikov@gmail.comhttps://orcid.org/0000-0002-8956-1765БиляловИ. Р.BilyalovI. R.

Билялов Ильдар Равильевич - ассистент кафедры факультетской хирургии № 1.

119435, Москва, ул. Большая Пироговская, 6, стр. 1

Ildar R. Bilyalov - Assistant professor, Department of Faculty Surgery № 1, Sechenov First Moscow State Medical University.

Bolshaya Pirogovskaya St. 6, building 1, Moscow, 119435

bilyalov_i_r@staff.sechenov.ruПервый Московский государственный медицинский университет имени И.М. СеченоваРоссияSechenov First Moscow State Medical UniversityRussian Federation202303052023016680Copyright © Комаров Р.Н., Осминин С.В., Новиков С.С., Билялов И.Р., 20232023Комаров Р.Н., Осминин С.В., Новиков С.С., Билялов И.Р.Komarov R.N., Osminin S.V., Novikov S.S., Bilyalov I.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.spractice.ru/jour/article/view/388

Рак желудка на протяжении долгих лет является одним из лидеров среди онкологических заболеваний по показателям смертности и заболеваемости. Заболеваемость раком проксимальной трети желудка увеличивается за последние годы. За весь период развития хирургии рака желудка было предложено множество способов реконструкций желудочно-кишечного тракта после проксимальной субтотальной резекции желудка (ПСРЖ). В мировой литературе наиболее часто встречаются пять типов реконструкций после ПСРЖ: интерпозиция тощей кишки, эзофагогастроанастомоз, реконструкция типа «двойной тракт», реконструкция типа «двойной лоскут», интерпозиция тощекишечного резервуара.

На основании 23 работ проведен сравнительный анализ 1517 случаев реконструкций после ПСРЖ из четырех стран мира (Россия, Япония, Китай, Южная Корея) за период с 2010 по 2021 г. Критериями сравнения стали длительность операций, интраоперационная кровопотеря, продолжительность пребывания в стационаре, а также послеоперационные осложнения (несостоятельность анастомоза, стриктура анастомоза, рефлюкс-эзофагит и парез культи желудка). Целью исследования - дать критическую оценку результатам в зависимости от типа реконструкции после ПСРЖ и выявить наиболее оптимальный способ восстановления целостности желудочно-кишечного тракта.

The study on gastrointestinal tract reconstruction after proximal gastrectomy (PG) for stomach cancer aimed to identify the most optimal way to restore the integrity of the gastrointestinal tract. The study involved a comparative analysis of 23 papers with a total of 1,517 cases of reconstructions after PG from four countries during the period 2010—2021. The five most commonly described types of reconstruction after PG were analyzed: jejunal interposition, esophagogastric anastomosis, ‘double tract' reconstruction, ‘double flap' reconstruction, and jejunal pouch interposition. The comparison criteria included the duration of surgeries, intraoperative blood loss, length of hospital stay, as well as postoperative complications such as anastomotic leakage, anastomotic stricture, reflux esophagitis, and residual food. The results of the study can provide valuable insights for surgeons in choosing the most optimal type of reconstruction after PG, thus reducing the risk of postoperative complications and improving the quality of life of patients with stomach cancer.

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The authors declare that there are no conflicts of interest present.