Comparative study of clinical efficacy of laparoscopic proximal gastrectomy with double-channel anastomosis and tubular gastroesophageal anastomosis.

Abstract

Background: According to statistics, the incidence of proximal gastric cancer has gradually increased in recent years, posing a serious threat to human health. Tubular gastroesophageal anastomosis and double-channel anastomosis are two relatively mature anti-reflux procedures. A comparison of these two surgical procedures, tubular gastroesophageal anastomosis and double-channel anastomosis, has rarely been reported. Therefore, this study aimed to investigate the effects of these two reconstruction methods on the quality of life of patients with proximal gastric cancer after proximal gastrectomy.

Aim: To compare short-term clinical results of laparoscopic proximal gastrectomy with double-channel anastomosis vs tubular gastric anastomosis.

Methods: Patients who underwent proximal gastrectomy at our hospital between January 2020 and January 2023 were enrolled in this retrospective cohort study. The patients were divided into an experimental group (double-channel anastomosis, 33 cases) and a control group (tubular gastric anastomosis, 30 cases). Baseline characteristics, surgical data, postoperative morbidities, and postoperative nutrition were recorded.

Results: The differences in baseline data, surgical data, and postoperative complications (20.0% vs 21.2%) were not statistically significant between the two groups. There were no statistically significant differences in the levels of postoperative nutrition indicators between the two groups of patients during the preoperative period and at 3 months postoperatively. In addition, the levels of postoperative nutrition indicators in patients in the experimental group declined significantly less at 6 months and 12 months postoperatively compared with those of the control group (P < 0.05). At 12 months postoperatively, the difference in anastomotic reflux esophagitis between the two groups was statistically significant (P < 0.05) with the experimental group showing less reflux esophagitis.

Conclusion: Both double-channel anastomosis and tubular gastric anastomosis after proximal gastrectomy are safe and feasible. Double-channel anastomosis has a better anti-reflux effect and is more beneficial in improving the postoperative nutritional status.