PMID- 38272976
OWN - NLM
STAT- MEDLINE
DCOM- 20240223
LR  - 20240224
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Print)
IS  - 0930-2794 (Linking)
VI  - 38
IP  - 3
DP  - 2024 Mar
TI  - Safety and short-term outcomes of a modified valvuloplastic esophagogastrostomy 
      versus gastric tube anastomosis after laparoscopy-assisted proximal gastrectomy: 
      a retrospective cohort study.
PG  - 1523-1532
LID - 10.1007/s00464-023-10663-0 [doi]
AB  - BACKGROUND: There is no optimal reconstruction method after proximal gastrectomy. 
      The valvuloplastic esophagogastrostomy can reduce postoperative reflux 
      esophagitis, but it is technically complex with a long operation time. The 
      gastric tube anastomosis is technically simple, but the incidences of reflux 
      esophagitis and anastomotic stricture are higher. METHODS: We have devised a 
      modified valvuloplastic esophagogastrostomy after laparoscopy-assisted proximal 
      gastrectomy (LAPG), the arch-bridge anastomosis. After reviewing our 
      prospectively maintained gastric cancer database, 43 patients who underwent LAPG 
      from November 2021 to April 2023 were included in this cohort study, with 25 
      patients received the arch-bridge anastomosis and 18 patients received gastric 
      tube anastomosis. The short-term outcomes were compared between the two groups to 
      evaluate the efficacy of the arch-bridge anastomosis. Reporting was consistent 
      with the STROCSS 2021 guideline. RESULTS: The median operation time was 180 min 
      in the arch-bridge group, significantly shorter than the gastric tube group 
      (p = 0.003). In the arch-bridge group, none of the 25 patients experienced 
      anastomotic leakage, while one patient (4%) experienced anastomotic stricture 
      requiring endoscopic balloon dilation. The postoperative length of stay was 
      shorter in the arch-bridge group (9 vs. 11, p = 0.034). None of the patients in 
      the arch-bridge group experienced gastroesophageal reflux and used proton pump 
      inhibitor (PPI), while four (22.2%) patients in the gastric tube group used PPI 
      (p = 0.025). The incidence of reflux esophagitis (Los Angeles grade B or more 
      severe) by endoscopy was lower in the arch-bridge group (0% vs. 25.0%). 
      CONCLUSION: The arch-bridge anastomosis is a safe, time-saving, and feasible 
      reconstruction method. It can reduce postoperative reflux and anastomotic 
      stricture incidences in a selected cohort of patients undergoing 
      laparoscopy-assisted proximal gastrectomy.
CI  - (c) 2024. The Author(s).
FAU - Li, Bailong
AU  - Li B
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Wang, Yinkui
AU  - Wang Y
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Wu, Zhouqiao
AU  - Wu Z
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Shan, Fei
AU  - Shan F
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Li, Shuangxi
AU  - Li S
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Jia, Yongning
AU  - Jia Y
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Miao, Rulin
AU  - Miao R
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Li, Zhemin
AU  - Li Z
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Xue, Kan
AU  - Xue K
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Yan, Chao
AU  - Yan C
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Li, Shen
AU  - Li S
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Ji, Jiafu
AU  - Ji J
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
FAU - Li, Ziyu
AU  - Li Z
AUID- ORCID: 0000-0001-5580-4979
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer 
      Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China. 
      ziyu_li@hsc.pku.edu.cn.
LA  - eng
GR  - 20220484111/Beijing Nova Program/
GR  - 202123/Beijing Hospitals Authority Innovation Studio of Young Staff Funding 
      Support/
GR  - PY202335/Science Foundation of Peking University Cancer Hospital/
PT  - Journal Article
DEP - 20240125
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
MH  - Humans
MH  - *Esophagitis, Peptic/etiology/prevention & control
MH  - Cohort Studies
MH  - Retrospective Studies
MH  - Constriction, Pathologic/surgery
MH  - *Laparoscopy/adverse effects/methods
MH  - Gastrectomy/adverse effects/methods
MH  - *Gastroesophageal Reflux/surgery
MH  - *Stomach Neoplasms/surgery/complications
MH  - Anastomosis, Surgical/adverse effects/methods
MH  - Postoperative Complications/epidemiology/etiology/prevention & control
PMC - PMC10881610
OTO - NOTNLM
OT  - Complication
OT  - Esophagogastrostomy
OT  - Laparoscopic surgery
OT  - Proximal gastrectomy
OT  - Reflux esophagitis
COIS- Bailong Li, Yinkui Wang, Zhouqiao Wu, Fei Shan, Shuangxi Li, Yongning Jia, Rulin 
      Miao, Zhemin Li, Kan Xue, Chao Yan, Shen Li, Jiafu Ji and Ziyu Li have no 
      conflicts of interest or financial ties to disclose.
EDAT- 2024/01/26 00:43
MHDA- 2024/02/23 06:43
PMCR- 2024/01/25
CRDT- 2024/01/25 23:20
PHST- 2023/09/30 00:00 [received]
PHST- 2023/12/22 00:00 [accepted]
PHST- 2024/02/23 06:43 [medline]
PHST- 2024/01/26 00:43 [pubmed]
PHST- 2024/01/25 23:20 [entrez]
PHST- 2024/01/25 00:00 [pmc-release]
AID - 10.1007/s00464-023-10663-0 [pii]
AID - 10663 [pii]
AID - 10.1007/s00464-023-10663-0 [doi]
PST - ppublish
SO  - Surg Endosc. 2024 Mar;38(3):1523-1532. doi: 10.1007/s00464-023-10663-0. Epub 2024 
      Jan 25.