{"title":"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)","authors":"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","doi":"10.1186/s12957-025-03900-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"263"},"PeriodicalIF":2.5000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A novel anti-reflux esophagogastric anastomosis in totally laparoscopic proximal gastrectomy: Hao's esophagogastrostomy by fissure technique (HEFT).\",\"authors\":\"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\",\"doi\":\"10.1186/s12957-025-03900-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":23856,\"journal\":{\"name\":\"World Journal of Surgical Oncology\",\"volume\":\"23 1\",\"pages\":\"263\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Surgical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12957-025-03900-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12957-025-03900-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
A novel anti-reflux esophagogastric anastomosis in totally laparoscopic proximal gastrectomy: Hao's esophagogastrostomy by fissure technique (HEFT).
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.
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.