A New Triangular Muscle Flap Esophagogastrostomy After Proximal Gastrectomy

Area of Science:

• Surgical Oncology
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Standardized proximal gastrectomy for upper-third gastric cancer (UGC) is limited by reflux and surveillance challenges.
• Current techniques often fail to prevent postoperative gastroesophageal reflux.
• Lack of standardized methods hinders effective treatment for UGC.

Purpose of the Study:

• To describe a novel triangular muscle flap technique for esophagogastrostomy in proximal gastrectomy.
• To evaluate the postoperative outcomes of this new surgical approach for UGC.
• To assess the efficacy of the technique in preventing reflux and facilitating surveillance.

Main Methods:

• Laparoscopic proximal gastrectomy was performed on 17 early-stage UGC patients.
• A novel triangular muscle flap was utilized for esophagogastrostomy.
• Postoperative outcomes, including reflux, complications, and tumor recurrence, were monitored.

Main Results:

• No in-hospital deaths occurred; two patients had early complications (pulmonary infection, abdominal abscess).
• No patients experienced reflux symptoms postoperatively.
• Esophagitis was observed in 16 patients (grade N/M, A, or B); all patients remained tumor-free.

Conclusions:

• The described triangular muscle flap technique for proximal gastrectomy is safe and effective.
• The technique demonstrates excellent gastroesophageal reflux prevention.
• Further multi-center studies are recommended to validate its efficacy.