Application of esophageal-tubular gastric asymmetric anastomosis in esophageal and esophagogastric junction cancer
10.3760/cma.j.cn441530-20250218-00066
- VernacularTitle:食管-管状胃不对称吻合术在胸腹腔镜食管癌和食管胃结合部肿瘤根治术中的应用
- Author:
Liqun PANG
1
;
Jian JI
;
Chenglin LI
;
Chao LIU
;
Jie ZHANG
;
Yan QIAN
;
Cong PANG
;
Song CHEN
;
Shangnong WU
;
Yunyun CHEN
;
Yanran QIN
;
Congxue XIE
Author Information
1. 南京医科大学附属淮安市第一人民医院胃肠外科，淮安 223000
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Esophagogastric junction neoplasms;
Digestive tract reconstruction;
Reflux esophagitis;
Bile reflux gastritis;
Esophageal tubular gas
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(10):1198-1202
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the anti-reflux effect of digestive tract reconstruction using esophageal-tubular gastric asymmetric anastomosis after radical resection of esophageal and esophagogastric junction cancer.Methods:The main steps were as follows:(1)oblique incision of the lower esophagus;(2)curved incision of the tubular anterior gastric wall;(3)the lower end of the esophagus was anastomosed to the tubular gastric incision with a 90-degree torsion; (4)The anterior wall of the anastomosis was reinforced with a transverse-inverted suture,the posterior wall with a folded suture,and the corners of the gastric stump were buried with sutures.The anastomosis operation time,postoperative complications and postoperative hospital stay were recorded;the reconstructed structure and anti-reflux effect of the anastomosis were observed by digestive tract radiography,gastroscopy and follow-up investigation.Results:The Department of Gastrointestinal and Thoracic Surgery of Huaian First People's Hospital, affiliated to Nanjing Medical University, treated 5 patients of esophagogastric junction cancer and 20 esophageal cancer cases between August 2022 and November 2024, including 19 men and 6 women, with a mean age of (66.7±7.4) years. The mean anastomosis time was (35.4±5.9) minutes, the intraoperative blood loss was (117.6±33.4) ml and the mean postoperative hospital stay was(16.6±5.2) days, with no complications such as anastomotic leakage and bleeding. Postoperative digestive tract radiography (Trendelenburg position)showed that all the patients had no contrast reflux,gastroscopy showed no signs of reflux esophagitis and bile reflux gastritis, the anastomosis showed an inverted whiskers valve-like structure. The median follow-up time was (16.8±6.3) months, and all patients had no reflux symptoms such as acid reflux and belching,and no acid suppressive medication was needed.Conclusion:The esophageal-tubular gastric asymmetric anastomosis is a safe and effective antireflux reconstruction technique.
