[Anti-reflux gastrointestinal reconstruction techniques after laparoscopic proximal gastrectomy]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Laparoscopic proximal gastrectomy is increasingly common.
• Traditional esophagogastric anastomosis can cause severe reflux esophagitis, impacting quality of life.
• Developing anti-reflux reconstruction methods is crucial for patient outcomes.

Purpose of the Study:

• To review and discuss various digestive tract reconstruction methods after laparoscopic proximal gastrectomy.
• To analyze anti-reflux mechanisms, efficacy, and surgical challenges of different techniques.
• To provide guidance on selecting appropriate reconstruction strategies.

Main Methods:

• Review of latest clinical studies and authors' clinical experience.
• Discussion of esophagogastric anastomosis techniques (e.g., posterior, anterior, gastric tube, lateral, Kamikawa).
• Discussion of esophagojejunal anastomosis techniques (e.g., jejunal interposition, pouch interposition, double-channel).

Main Results:

• Multiple reconstruction methods exist, offering varying degrees of reflux control.
• Each method has distinct anti-reflux mechanisms and surgical complexities.
• Laparoscopic approaches present unique technical considerations.

Conclusions:

• The choice of reconstruction method should be individualized.
• Consideration of patient-specific factors and surgeon's technical proficiency is essential.
• Optimizing anti-reflux strategies improves post-gastrectomy quality of life.