Background: Laparoscopic proximal gastrectomy with an anti-reflux
procedure, as a function-preserving surgery, has been a common treatment
strategy for proximal early gastric cancer. This study aimed to develop
a new surgical technique for these patients. Methods: Laparoscopic
proximal gastrectomy with vagus nerve preservation and double-flap
technique was performed in patients who could retain two-thirds of the
stomach. The hepatic branches and the celiac branches were both
preserved. A seromuscular double-flap was created through the auxiliary
incision, and the anastomosis was performed under laparoscopy. The
detailed surgical procedure and preliminary results were presented.
Results: Six patients underwent this procedure with no conversion to
open surgery. No intraoperative and postoperative complications occurred
during the perioperative period. No patients showed diarrhea and
appetite loss, and body weight regained preoperative level 6 month
later. No food residue and reflux esophagitis were observed via
endoscopic examination. Gallbladder contraction was observed in all the
patients by ultrasonography after high-fat diet. Conclusion: Although
long-term follow up and a larger number of patients are required to
evaluate the functional outcomes, this new technique provides a
minimally invasive surgical option for proximal early gastric cancer,
especially in the cardiac area.
Laparoscopic proximal gastrectomy with double‐flap technique
versus
laparoscopic subtotal gastrectomy for proximal early gastric cancer
