Feasibility and outcomes of laparoscopic proximal gastrectomy with Kamikawa double-flap reconstruction for upper - third gastric cancer

Abstract

Abstract Introduction: Laparoscopic Proximal Gastrectomy (LPG) is a priority selection for early cancer, submucosal tumor in the cardia location. However, the optimal method for reconstruction of intestinal circulation is still debated, especially regarding post-operative life quality. This study aimed to evaluate the feasibility, result and post-operativequality of life ofa LPG with double-flap technique for reconstruction of digestive tract using Kamikawa technique - double flap (DFT). Patients and method: A retrospective study was performed on 18 patients with early cancer, submucosal tumors in the 1/3 upper or cardia location undergoing LPG – DFT Kamikawa technique 5/2018 to 4/2022 at Digestive Surgery Department, University Medical Center, HCMC. We evaluated clinical data and operation results. Results: Median age was 52 years. The operating time was 265 minutes, and the mean time to perform anastomosis was 85 minutes. There were 4 with early-stage adenocarcinoma, 10 patients with GIST, and 4 with leiomyoma. All cases were free of cancer cells in the surgical resection specimens. There were no intraoperative complications or postoperative complications. There was no postoperative mortality. The mean follow-up time was 20,3 months. Quality of life improved over time: the scores at 6, 12, and 24 months were: 25.7 ± 11.6, 21.3 ± 6.2, and 19.6 ± 3.9, respectively. The average hospital stay was 6,3 days. Conclusions: LPG –DFT by Kamikawa technique is safe, feasible and patients quality of life were acceptable. Keywords: Gastric cancer, proximal gastrectomy, double-flap reconstruction, Kamikawa