Side overlap esophagogastrostomy to prevent reflux after proximal gastrectomy

Yamashita, Yoshito; Yamamoto, Atsushi; Tamamori, Yutaka; Yoshii, Mami; Nishiguchi, Yukio

doi:10.1007/s10120-016-0674-5

Cited by 90 publications

(78 citation statements)

References 10 publications

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“…Excessive overlapping of the valve is likely to cause ischaemic necrosis of the valve or anastomotic stenosis. Yoshito Yamashita [22] et al reported an anastomotic anti-reflux method of oesophageal-remnant stomach side overlap via a linear cutter stapler under complete laparoscopy. We believe that in this method, a long segment of the lower oesophagus needs to be reserved, which cannot guarantee upper margin R0 resection of Siewert II AEG tumours with dentate line invasion.…”

Section: Discussionmentioning

confidence: 99%

Semi-embedded valve anastomosis a new anti-reflux anastomotic method after proximal gastrectomy for adenocarcinoma of the oesophagogastric junction

Wang

et al. 2020

BMC Surg

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Background There is a high probability of gastroesophageal reflux after laparoscopic proximal gastrectomy for adenocarcinoma of the oesophagogastric junction (AEG). Various anti-reflux anastomotic methods are emerging in clinical practice; however, none of them have been widely accepted. We have innovated a new type of anti-reflux anastomotic method, named semi-embedded valve anastomosis. The aim of this study was to explore the feasibility and anti-reflux effect of the new anastomotic method. Methods The clinical data of 28 patients with Siewert II AEG who were treated by semi-embedded valve anastomosis were collected. The key point of the operation is to reconstruct a simulated valve and form an anti-reflux barrier similar to the physiological mechanism. The gastroesophageal reflux disease questionnaire (GerdQ) and classification of gastroesophageal reflux under electron microscopy were used to evaluate gastroesophageal reflux after the operation. Results The mean operative duration was 164.3 ± 19.0 min, the median intraoperative haemorrhage volume was 65 ml, the average number of lymph nodes dissected was 23 ± 2.6, the time for valve construction was 15.8 ± 3.2 min, the time for anastomotic reconstruction was 35.4 ± 4.8 min, the median time to first flatus was 3 d, and the median hospitalization duration was 12 d. There was one case of postoperative anastomotic stenosis. The GerdQ score [median (range)] was as follows: 2 (0–6), preoperation; 0 (0–8), 1 month postoperation; 2 (0–12), 3 months postoperation; and 3 (0–12), 6 months postoperation. The Wilcoxon signed-rank sum test was carried out at different times after the operation and the day before the operation, and the differences were not significant. There was one case of grade B gastroesophageal reflux according to the Los Angeles classification system among the gastrofibroscopic re-examination reports of 28 cases. Conclusion Semi-embedded valve anastomosis is safe and feasible after proximal gastrectomy for Siewert II AEG and has good anti-reflux effects.

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Section: Discussionmentioning

confidence: 99%

Semi-embedded valve anastomosis a new anti-reflux anastomotic method after proximal gastrectomy for adenocarcinoma of the oesophagogastric junction

Wang

et al. 2020

BMC Surg

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“…In a recent paper, Yamashita et al [32] proposed a side overlap esophagogastrostomy to prevent reflux after PG, with excellent results in patients undergoing this procedure.…”

Section: Discussionmentioning

confidence: 99%

Total vs proximal gastrectomy for adenocarcinoma of the upper third of the stomach: a propensity-score-matched analysis of a multicenter western experience (On behalf of the Italian Research Group for Gastric Cancer–GIRCG)

et al. 2018

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“…Reflux esophagitis is a major concern after PG. In several studies addressing this concern, it has been reported that direct anastomosis between the esophagus and the remaining stomach may lead to significant gastroesophageal reflux, esophagitis, and stricture at varying degrees (18,19). Reflux symptoms after PG are one of the leading causes of pain and impaired quality of life after surgery in patients with gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Proximal Versus Total Gastrectomy in the Surgical Treatment of Proximal Gastric Cancers

Talih¹,

Patmano²,

Dal³

et al. 2020

Erciyes Med J

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Objective:The shift in stomach cancer localization has led to new perspectives in the treatment of proximal one-third of the stomach cancer, focusing on the type of resection between total gastrectomy and proximal gastrectomy. We compared the results of patients with proximal gastric cancer, which were treated either with PG or TG regarding postoperative complications, symptoms of reflux esophagitis, the number of dissected lymph nodes, short-term survival, and the compliance to the postoperative planned diet. Materials and Methods:This study included 58 patients who underwent surgery for proximal gastric adenocarcinoma. Of the patients, 32 patients underwent total gastrectomy, while 26 patients underwent proximal gastrectomy. The total and proximal gastrectomy groups were retrospectively compared concerning the number of lymph nodes dissected, postoperative reflux symptoms, dietary compliance, and short-term survival.Results: Reflux symptoms were seen in 10 patients (31.2%) who underwent total gastrectomy versus in 12 patients (46.1%) treated with proximal gastrectomy (p=0.08). Mean number of lymph nodes dissected was 24.6±13.5 in patients treated with total gastrectomy, whereas 18.8±6.1 in patients who underwent proximal gastrectomy (p=0.06). Dietary compliance was better in the PG group (p=0.03), while no significant differences were detected between groups about postoperative complications and short-term survival. Conclusion:In the surgical treatment of proximal gastric cancers, proximal gastrectomy performed using an anti-reflux technique, maybe an alternative to total gastrectomy, providing better functional results without compromising oncologic principles. MATERIALS and METHODSThis retrospective study enrolled 58 proximal gastric adenocarcinoma (adenocarcinoma of the proximal one-third

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Side overlap esophagogastrostomy to prevent reflux after proximal gastrectomy

Abstract: SOFY can be easily performed laparoscopically and may overcome the problems of postoperative reflux and stenosis.

Cited by 90 publications

References 10 publications

Semi-embedded valve anastomosis a new anti-reflux anastomotic method after proximal gastrectomy for adenocarcinoma of the oesophagogastric junction

Semi-embedded valve anastomosis a new anti-reflux anastomotic method after proximal gastrectomy for adenocarcinoma of the oesophagogastric junction

Total vs proximal gastrectomy for adenocarcinoma of the upper third of the stomach: a propensity-score-matched analysis of a multicenter western experience (On behalf of the Italian Research Group for Gastric Cancer–GIRCG)

Comparison of Proximal Versus Total Gastrectomy in the Surgical Treatment of Proximal Gastric Cancers

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