[Chinese consensus on digestive tract reconstruction after proximal gastrectomy (2024 edition)].

Abstract

The incidence of adenocarcinoma of the esophagogastric junction has been gradually increasing in recent years. Due to the smaller resection range, partial preservation of the function of stomach, high safety, better postoperative nutritional status, and lesser negative psychological impact on patients, the application of proximal gastrectomy has increased significantly. Proximal gastrectomy disrupts the normal anatomical structure of the esophagogastric junction, resulting in permanent loss of the anti-reflux function of the cardia. At the same time, the retained pylorus may lead to delayed gastric emptying, making it prone to the complications such as reflux esophagitis and anastomotic stenosis. In recent years, various anti-reflux digestive tract reconstruction methods have emerged, allowing proximal gastrectomy to partially preserve stomach function while avoiding severe postoperative reflux esophagitis. This consensus, based on the "Chinese consensus on digestive tract reconstruction after proximal gastrectomy (Version 2020)", updates the research findings of multiple anti-reflux surgical techniques. It aims to promote the technical points of various proximal gastrectomy digestive tract reconstruction techniques, evaluate their anti-reflux efficacy, and provide guidance for the clinical application of digestive tract reconstruction after proximal gastrectomy.