Research progress of anti reflux digestive tract reconstruction for proximal gastrectomy

doi:10.16139/j.1007-9610.2023.04.017

Abstract

Abstract:

The incidence rate of proximal gastric cancer in China and some Asian countries is increasing year by year. Surgery is the most effective and commonly used treatment for proximal gastric cancer. Traditional total gastrectomy has a good curative effect, but its complications, such as dystrophic metabolism and decreased quality of life, limited its use. In recent years, the proximal gastrectomy carried out clinically can remove tumor tissue and preserve part of gastric tissue, which is conducive to improving the postoperative nutritional status of patients. However, during proximal gastrectomy, the esophageal sphincter and His angle were damaged, resulting in residual gastric acid reflux and gastroesophageal reflux, resulting in reflux esophagitis, which also affected the quality of life of the patients. In order to solve these problems, surgeons have explored different digestive tract reconstruction methods. So far, many digestive tract reconstruction methods have been reported. This paper introduced the commonly used digestive tract reconstruction methods, and summarized the literature on postoperative quality of life and survival outcomes, so as to provide reference and choice for surgeons.

Key words: Proximal gastric cancer, Proximal gastrectomy, Reflux esophagitis, Digestive tract reconstruction

CLC Number:

R735.2
R571

SUN Qiang, YAO Jun, ZHANG Xin, DU Shanshan, WANG Weijun. Research progress of anti reflux digestive tract reconstruction for proximal gastrectomy[J]. Journal of Surgery Concepts & Practice, 2023, 28(04): 388-393.

Figures/Tables 9

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Author	Type of anastomosis	Number of anastomoses	Patients (male/female)	Reflux esophagitis [n（%）]
Nakamura, et al^[10]	Traditional EG	1	64(49/15)	15/55(27.3)
Yamasaki, et al^[5]	Tube-like stomach EG	1	115(88/27)	20/115(17.4)
Tsumura, et al^[6]	DFT	1	19(16/3)	0
Yamashita, et al^[19]	SOFY	1	14(11/3)	1/10(10.0)
Nomura, et al^[7]	JI	3	15(11/4)	1/156.7)
Yamasaki, et al^[5]			34(22/12)	3/34 (8.8)
Nakamura, et al^[10]	JPI	3	12(9/3)	2/12 (16.7)
Hong, et al^[23]	DTR	3	21(16/5)	0
Ji, et al^[22]			25(24/1)	2/25(8.0)
Nomura, et al^[7]			15(13/2)	1/15 (6.7)
Nomura, et al^[29]	Modified-DTR	3	10(7/3)	1/10 (10.0)
Nomura, et al^[7]			15(11/4)	1/15 (6.7)

Author	Year	Surgical method	Sex (male/female)	Average weight recovery (%)	Increased hemoglobin (g/L)	Increased albumin (g/L)	Average food intake recovery (%)
Ichikawa, et al^[3]	2014	TG	29/6	85.3	29.7±5.4	15.7±3.6	93.4
		PG	34/15	90.2^a)	42.5±6.7^a)	20.8±3.2^a)	99.1^a)
Yamasaki, et al^[5]	2020	TG	67/26	86.2	30.5±5.9	16.4±3.8	92.5
		PG	116/43	88.9	44.8±6.2^a)	19.8±4.1^a)	98.4^a)
Masuzawa, et al^[4]	2014	TG	89/33	87.9	27.4±5.3	15.5±3.2	94.8
		PG-EG	36/13	91.6	47.1±5.9^a)	20.1±3.8^a)	99.2^a)
Tsumura, et al^[6]	2020	TG	11/6	86.5	28.4±4.7	17.4±4.2	93.7
		PG	16/3	89.4	40.8±5.4^a)	20.9±4.3^a)	98.9^a)