clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2020-98-11-12-752-758clinmed-157Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESРеконструктивный этап операции после проксимальной резекции желудкаReconstructive stage of surgery after cardiectomyТишаковаВ. Э.TishakovaV. E.

Тишакова Виктория Эдуардовна — врач — хирург-онколог

107014, Москва

Victoriya E. Tishakova — doctor-oncologist-surgeon

107014, Moscow

tishakova21@gmail.comРучкинД. В.RuchkinD. V.

117997, Москва

117997, Moscow

БондаренкоА. В.BondarenkoA. V.

142110, Подольск

142110, Podolsk

Филиал № 1 ФГБУ «Главный военный клинический госпиталь им. академика Н.Н. Бурденко» Минобороны РоссииРоссияMain Military Clinical Hospital named after Burdenko N.N. of the Ministry of Defense of the Russsia, Branch № 1Russian FederationФГБУ «Национальный медицинский исследовательский центр хирургии им. А.В. Вишневского» Минздрава РоссииРоссияVishnevsky A.V. National Medical Research Center of SurgeryRussian FederationВоенный госпиталь Минобороны РоссииРоссияMilitary hospital of the Ministry of defense of the Russian FederationRussian Federation2020170420219811-12752759Copyright © Тишакова В.Э., Ручкин Д.В., Бондаренко А.В., 20212021Тишакова В.Э., Ручкин Д.В., Бондаренко А.В.Tishakova V.E., Ruchkin D.V., Bondarenko A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/157

До настоящего времени отсутствует единое мнение относительно операции выбора при патологических изменениях проксимального отдела желудка, дистального отдела пищевода и области кардиоэзофагеального перехода. Помимо злокачественных новообразований и язвенной болезни показанием к выполнению проксимальной резекции с реконструкцией может являться рефрактерное течение гастроэзофагеальной рефлюксной болезни (ГЭРБ) и отсутствие какого-либо эффекта от первичной антирефлюксной операции. Для принятия решения о методе выбора хирургического лечения патологий дистального отдела пищевода и проксимального отдела желудка необходимо сравнение профилей эффективности и безопасности указанных методик по многим параметрам. Основными показателями, характеризующими эффективность реконструктивных операций после проксимальной резекции желудка, являются частота и тяжесть развития большой группы функциональных расстройств, характеризуемых как «болезни оперированного желудка», или «постгастрорезекционные расстройства». Предложено и изучено огромное количество различных конструкций анастомозов после проксимальной резекции желудка. Тем не менее беспристрастная оценка результатов применения этих соустий свидетельствует о том, что возлагаемые на них надежды в большинстве случаев не оправдались, что говорит о недостаточной освещенности данной проблемы в научной литературе, несмотря на сохраняющийся интерес хирургов.

There is no consensus regarding the operation of choice for pathological changes in the proximal stomach, distal esophagus and the area of the cardio-esophageal junction to the present day. In addition to malignancy and peptic ulcer disease, a refractory course of gastroesophageal reflux disease (GERD) and the absence of any effect from primary antireflux surgery may be an indication for performing cardiectomy with reconstruction. To make a choice of the surgical treatment for pathologies of the distal esophagus and proximal stomach method, it is necessary to compare the efficiency and safety profiles of these techniques in many parameters. The main indicators of the effectiveness of reconstructive operations after cardiectomy, are the frequency and severity of a large group of functional disorders characterized as “dumping syndrome” or “postgastrectomy syndrome”. A huge number of different types of anastomosis after cardiectomy has been proposed and studied. Nevertheless, an an objective evaluation of the results of these anastomosis types’ use, indicates that the hopes placed on them did not come true in most cases. It indicates insufficient coverage of this problem in scientific literature, despite the continuing interest of surgeons.

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