Preliminary report on the use of total lumpectomyconical remnant gastric - esophagus side overlap anastomosis in radical resection of Siewert type II proximal gastric cancer
10.3760/cma.j.cn441530-20220930-00397
- VernacularTitle:全腔镜锥形残胃与食管侧壁重叠吻合成形术在SiewertⅡ型近端胃癌根治切除术中的初步应用报告
- Author:
Liming WANG
1
;
Haoyue MA
;
Peng SUN
;
Shou LUO
;
Yusong LUAN
;
Peide REN
;
Xuhao CAI
;
Huijing CHANG
;
Panxin PENG
;
Yonggang YU
;
Yangyang WANG
;
Bolun SONG
;
Weiguo XU
;
Yinggang CHEN
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院深圳医院胃肠外科，深圳 518116
- Keywords:
Esophagogastric junction adenocarcinoma;
Laparoscopic proximal gastrectomy;
Conical remnant gastric-esophagus side overlap anastomosis;
Esophageal reflux
- From:
Chinese Journal of Gastrointestinal Surgery
2023;26(9):885-888
- CountryChina
- Language:Chinese
-
Abstract:
Objective:There is no standard method for esophageal remnant gastric reconstruction for proximal gastrectomy. Reflux esophagitis caused by esophagogastrostomy remains a difficult surgical problem. To report the preliminary surgical results of novel esophagus-conical remnant gastric side overlap anastomosis (CGEO) , with particular emphasis on postoperative esophageal reflux.Methods:In June 2022, we developed a novel CGEO for laparoscopic proximal gastrectomy on two patients with Siewert type II esophagogastric junction adenocarcinoma. Surgical procedures for CGEO: (1) Laparoscopic proximal gastrectomy and preparation of conically shaped gastric remnant; (2) Determining anastomotic site of residual stomach and esophagus; (3) Side-to-side anastomosis of right esophageal wall to anterior of conical gastric remnant; (4) Valvuloplasty of esophageal stump.Results:Case 1 was a 71-year-old man with an operation time of 305 minutes and was successfully discharged from the hospital on the 9th day after surgery, and the postoperative pathology was T3N0M0. Case 2 was an 82-year-old man with an operation time of 325 minutes. He was discharged on the 10th day after surgery. In both cases, only mild esophageal mucosal changes were seen in gastroscopy, there were no obvious symptoms of esophageal reflux. There was also no significant weight change at half a year after operation.Conclusion:CGEO is moderately safe in radical surgery for proximal gastric cancer, and may have a preventive effect on the occurrence of postoperative esophageal reflux, but long-term results need to be confirmed by further studies with follow-up.
