Anti-reflux gastrointestinal reconstruction techniques after laparoscopic proximal gastrectomy.
10.3760/cma.j.cn441530-20220308-00093
- Author:
Lin Jun WANG
1
;
Zheng LI
1
;
Ze Kuan XU
1
Author Information
1. Department of General Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
- Publication Type:Journal Article
- Keywords:
Anti-reflux;
Digestive tract reconstruction;
Laparoscopy;
Proximal gastrectomy
- MeSH:
Anastomosis, Surgical/methods*;
Esophagitis, Peptic/surgery*;
Gastrectomy/methods*;
Humans;
Jejunum/surgery*;
Laparoscopy;
Quality of Life;
Retrospective Studies;
Stomach Neoplasms/surgery*
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(5):367-372
- CountryChina
- Language:Chinese
-
Abstract:
Laparoscopic techniques are more and more poplular in proximal gastrectomy. The traditional esophagogastric anastomosis may lead to severe reflux esophagitis after surgery, affecting patient's quality of life. In recent years, multiple methods of digestive tract reconstruction after laparoscopic proximal gastrectomy capable of resisting reflux have been applied to the clinic. Combining the results of the latest clinical studies and our clinical experience, we elaborate the views on digestive tract reconstruction after laparoscopic proximal gastrectomy. Esophagogastric anastomosis (posterior esophagogastric anastomosis, anterior esophagogastric anastomosis, gastric tube reconstruction, lateral esophagogastric anastomosis, Kamikawa anastomosis and modified Kamikawa anastomosis, etc.) and esophagojejunal anastomosis (interposition jejunum, interposition jejunum with pouch, and double-channel anastomosis, etc.) are mainly discussed. Of course, the anti-reflux mechanisms of different surgical procedures are not the same, the anti-reflux effects are variable, and the surgical difficulties under laparoscopy are also different. Therefore, how to choose a rational reconstruction method after proximal gastrectomy needs to be comprehensively considered based on patient's own situation and technical level of the surgeons.
