Tunnel Anastomosis vs Double-Tract Jejunal Interposition Reconstruction After Proximal Gastrectomy: Protocol for a...

Area of Science:

• Gastroenterology and Surgical Oncology
• Digestive Tract Reconstruction Techniques
• Post-Gastrectomy Complication Management

Background:

• Proximal gastrectomy often requires complex digestive tract reconstruction.
• Tunnel anastomosis is a novel technique with a demonstrated favorable antireflux effect.
• Current standard reconstruction methods may be associated with postoperative reflux esophagitis.

Purpose of the Study:

• To prospectively compare the efficacy and safety of tunnel anastomosis versus double-tract jejunal interposition.
• To evaluate tunnel anastomosis's non-inferiority in preventing reflux esophagitis post-proximal gastrectomy.
• To assess the impact of different reconstruction techniques on patient quality of life and nutritional status.

Main Methods:

• A multicenter prospective randomized controlled study involving 240 patients undergoing proximal gastrectomy.
• Patients are randomized into two groups: tunnel anastomosis (120) and double-tract jejunal interposition (120).
• Clinical assessments and questionnaires are administered preoperatively and at 3, 6, and 12 months postoperatively, with reflux esophagitis as the primary endpoint.

Main Results:

• Patient recruitment began in March 2022 and is ongoing until February 2027.
• Full patient follow-up is scheduled for completion by February 2028.
• Primary and secondary endpoint data are currently being collected and analyzed.

Conclusions:

• This is the first prospective study evaluating tunnel anastomosis for proximal gastrectomy reconstruction.
• The study aims to provide novel insights into optimizing digestive reconstruction methods.
• Findings will inform clinical practice regarding the management of post-gastrectomy complications.