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01-06-2020 | Valvuloplasty | How-I-Do-It articles

Non-flap hand-sewn esophagogastrostomy as a simple anti-reflux procedure in laparoscopic proximal gastrectomy for gastric cancer

Authors: Shuhei Komatsu, Toshiyuki Kosuga, Takeshi Kubota, Tatsuya Kumano, Kazuma Okamoto, Daisuke Ichikawa, Yasuhiro Shioaki, Eigo Otsuji

Published in: Langenbeck's Archives of Surgery | Issue 4/2020

Abstract

Aims

No ideal and generally accepted method of reconstruction for laparoscopic proximal gastrectomy (LPG) has been established because of a high incidence of postoperative reflux and anastomotic stenosis. The aim of this study was to evaluate the short-term outcomes of LPG with a non-flap hand-sewn technique as a simple anti-reflux procedure for the upper part of clinical Stage I gastric cancer.

Methods

Between November 2016 and June 2019, 23 consecutive gastric cancer patients, who underwent curative LPG with lymphadenectomy, were enrolled in the study. In this study, we devised a simple hand-sewn technique for esophagogastrostomy, which comprises a 5-cm pseudo-fornix as a fundoplication, the posterior pressure mechanism by the remnant stomach and bilateral crus, and a flat-shaped anastomotic hole as a valvuloplasty.

Results

The median operation time and hospital stay was 325 min and 10 days, respectively. There was no patient with anastomotic leakage and delayed gastric empting. No patient had symptoms of gastroesophageal reflux, but two patients (8.6% (2/23): Grade M and Grade A) had endoscopic findings during a follow-up period of more than 6 months. There was no patient with Grade B or more severe reflux esophagitis. One patient (4.3%, 1/23) developed anastomotic stenosis, which was resolved with endoscopic dilatation. The mean body weight loss at 6 months after surgery was 7.5% in comparison with the preoperative body weight.

Conclusion

Our non-flap hand-sewn technique for esophagogastrostomy had favorable outcomes and might be one of reliable techniques as an anti-reflux procedure in LPG for gastric cancer.

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Title: Non-flap hand-sewn esophagogastrostomy as a simple anti-reflux procedure in laparoscopic proximal gastrectomy for gastric cancer
Authors: Shuhei Komatsu
Toshiyuki Kosuga
Takeshi Kubota
Tatsuya Kumano
Kazuma Okamoto
Daisuke Ichikawa
Yasuhiro Shioaki
Eigo Otsuji
Publication date: 01-06-2020
Publisher: Springer Berlin Heidelberg
Keywords: Valvuloplasty
Esophagitis
Gastrectomy
Gastric Cancer
Valvuloplasty
Valvuloplasty
Gastric Cancer
Gastric Fundoplication
Gastric Fundoplication
Gastrectomy
Published in: Langenbeck's Archives of Surgery / Issue 4/2020
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-020-01900-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Non-flap hand-sewn esophagogastrostomy as a simple anti-reflux procedure in laparoscopic proximal gastrectomy for gastric cancer

Abstract

Aims

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Aims

Methods

Results

Conclusion

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