A novel anti-reflux esophagogastric anastomosis in totally laparoscopic proximal gastrectomy: Hao's esophagogastrostomy by fissure technique (HEFT).

IF 2.5 3区 医学 Q3 ONCOLOGY
Ze-Qin Wang, Wen-Liang Cui, Yan-Feng Zhu, Ming-Ye Ma, Jian Wang, Zi-Hao Wang, Ya-Ping Wang, Jun Hong, Han-Kun Hao
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引用次数: 0

Abstract

Background: For adenocarcinoma localized at the gastroesophageal junction and the upper third of the stomach, proximal gastrectomy (PG) is a commonly used surgical method that preserves gastric function. For reconstruction after PG, an effective anti-reflux technique is crucial. This study proposes a novel fundoplication and valvuloplasty esophagogastrostomy technique, named as Hao's esophagogastrostomy by fissure technique (HEFT).

Methods: A retrospective analysis was conducted on the clinical data of 11 consecutive cases that underwent totally laparoscopic proximal gastrectomy with HEFT at Huashan Hospital, Fudan University from September 2021 to January 2024. The demographics and clinics pathologic profiles, preoperative details, and postoperative outcomes of the patients were analyzed. And the reflux conditions were evaluated 6 months after surgery by endoscopy.

Results: All 11 patients successfully underwent the totally laparoscopic surgery. The operative time was 190 (150, 240) minutes, including a reconstruction duration of 30 (25, 30) minutes. No Clavien-Dindo grade II or higher complications occurred postoperatively, and the hospital stay was 6 (5, 7) days. Endoscopic findings at 6 months postoperatively indicated 2 cases of LA grade A esophagitis. Among them, 1 patient experienced reflux symptoms after overeating, which improved after using proton pump inhibitor drugs. Notably, there were no occurrences of anastomotic stenosis.

Conclusion: HEFT presents a promising approach for anti-reflux reconstruction following proximal gastrectomy (PG), simplifying the surgical technique while maintaining favorable immediate clinical outcomes. However, given that this is a retrospective study, further research with larger-scale clinical trials and long-term follow-up is essential to validate its safety, efficacy, and long-term benefits.

全腹腔镜胃近端切除术中一种新型抗反流食管胃吻合术:郝氏食管胃吻合术(HEFT)
背景:对于胃食管交界处和胃上三分之一的腺癌,近端胃切除术(PG)是一种常用的保留胃功能的手术方法。对于PG术后重建,有效的抗反流技术至关重要。本研究提出了一种新的食管胃吻合技术,称为郝氏食管胃吻合术(HEFT)。方法:回顾性分析复旦大学华山医院自2021年9月至2024年1月连续11例采用HEFT全腹腔镜胃近端切除术的临床资料。分析患者的人口统计学和临床病理资料、术前细节和术后结果。术后6个月通过内窥镜评估反流情况。结果:11例患者均成功行全腹腔镜手术。手术时间190(150,240)分钟,其中重建时间30(25,30)分钟。术后无Clavien-Dindoⅱ级及以上并发症发生,住院时间6 (5,7)d。术后6个月内镜检查显示2例LA级食管炎。其中1例患者暴饮暴食后出现反流症状,经使用质子泵抑制剂药物后好转。值得注意的是,没有发生吻合口狭窄。结论:HEFT是近端胃切除术(PG)后抗反流重建的一种有前景的方法,简化了手术技术,同时保持了良好的即时临床效果。然而,鉴于这是一项回顾性研究,进一步的大规模临床试验和长期随访研究是必要的,以验证其安全性、有效性和长期获益。
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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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