Fundus rotation gastroplasty: rationale, technique and results

Area of Science:

• Gastroenterology
• Surgical Oncology
• Thoracic Surgery

Background:

• Anastomotic leakage significantly increases postoperative morbidity and mortality following esophageal resection.
• Compromised blood supply to the gastric tube and suture line tension are primary causes of anastomotic insufficiency.

Purpose of the Study:

• To introduce and evaluate the fundus rotation gastroplasty (FRG) as a novel technique for esophageal reconstruction.
• To assess the safety and efficacy of FRG in preventing anastomotic leakage.

Main Methods:

• The study details the rationale and surgical technique of fundus rotation gastroplasty (FRG).
• Early clinical results of patients undergoing FRG for esophageal reconstruction were analyzed.

Main Results:

• Fundus rotation gastroplasty (FRG) demonstrated improved perfusion of the gastric tube's oral segment.
• FRG provided increased gastric tube length, facilitating safer pharyngeal anastomoses with a low insufficiency rate of 9%.
• The technique preserved gastric reservoir function, supporting physiological digestion.

Conclusions:

• Fundus rotation gastroplasty (FRG) is a safe and effective alternative for esophageal reconstruction.
• FRG offers advantages over conventional gastroplasties, particularly for high anastomotic sites, by enhancing perfusion and tube length.