引用文本：缪宜宸, 闫竞一, 程骏, 等. 高位食管胃结合部腺癌行消化道重建：右经胸后开襟单肌瓣成形术的技术要点[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(2): 309-316.

作者：缪宜宸1，闫竞一1，程骏1，陈笑雷1，金劲激1，董千铜1，林季1，黄冬冬1，刘舒1，陈伟哲1，阮小蛟1，张翔2，钱军3，余春3，江德军3，鲁航3

单位：1. 温州医科大学附属第一医院胃肠外科，浙江 温州 325035；2. 温州医科大学附属第一医院胸外科，浙江 温州 325035；3. 温州医科大学附属衢州医院（衢州市人民医院）胃肠外科，浙江 衢州 324000

Authors：Miao Yichen1, Yan Jingyi1, Cheng Jun1, Chen Xiaolei1, Jin Jinji1, Dong Qiantong1, Lin Ji1, Huang Dongdong1, Liu Shu1, Chen Weizhe1, Ruan Xiaojiao1, Zhang Xiang2, Qian Jun3, Yu Chun3, Jiang Dejun3, Lu Hang3

Unit：1. Department of Gastrointestinal Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, Zhejiang, China；2. Department of Thoracic Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, Zhejiang, China；3. Department of Gastrointestinal Surgery, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou 324000, Zhejiang, China

摘要：

高位食管胃结合部腺癌因其特殊的解剖生理结构，存在多种手术方案选择，但目前未有公认的首选术式。本研究团队在“基于管状胃的右开襟单肌瓣成形术”手术经验之上，结合食管癌相关手术方式，提出了“右经胸后开襟单肌瓣成形术”，其具有淋巴结清扫更彻底、对心肺功能影响更小，以及保功能、预防吻合口漏、抗反流等优势。本文归纳整理了手术适应证、禁忌证、术前准备、手术操作、并发症预防和处理等内容，旨在推动该术式的临床应用。

关键词：高位食管胃结合部腺癌；右胸入路；消化道重建；后开襟单肌瓣成形术；吻合口漏；反流性食管炎

Abstract：

Adenocarcinoma of the high esophagogastric junction, owing to its distinct anatomical and physiological features, has multiple surgical options, yet no universally accepted optimal procedure has been established. Building upon our experience with the “right-opening single flap valvuloplasty based on tubular stomach” and integrating relevant techniques from esophageal cancer surgery, our team has developed the “right transthoracic posterior-opening single flap valvuloplasty”. This novel technique offers several advantages, including extended lymph node dissection, reduced cardiopulmonary impact, functional preservation, prevention of anastomotic leakage, and effective anti‑reflux outcomes. Accordingly, this article systematically reviews and summarizes the surgical indications, contraindications, preoperative preparation, operative techniques, prevention and management of complications, aiming to promote the wider application of this procedure.

Key words：Adenocarcinoma of high esophagogastric junction; Right thoracic approach; Digestive tract reconstruction; Posterior approach single‑flap valvuloplasty; Anastomotic leakage; Reflux esophagitis

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