Proximal gastrectomy with anti‑reflux anastomosis for patients with adenocarcinoma of the esophagogastric junction: The simple and safe triangle‑valve technique

Gao,Yongshun; Sun,Jiangang; Chen,Yuheng; Zhang,Yunfei; Chen,Peng; Zong,Liang; Huang,Jingjing; Han,Ji; Chen,Xiaoping

doi:10.3892/mco.2020.2132

Proximal gastrectomy with anti‑reflux anastomosis for patients with adenocarcinoma of the esophagogastric junction: The simple and safe triangle‑valve technique

Authors:
- Yongshun Gao
- Jiangang Sun
- Yuheng Chen
- Yunfei Zhang
- Peng Chen
- Liang Zong
- Jingjing Huang
- Ji Han
- Xiaoping Chen
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Affiliations: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China, Cancer Foundation of China, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China, Medical Research Center, Su Bei People's Hospital of Jiangsu Province, Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
Published online on: September 7, 2020 https://doi.org/10.3892/mco.2020.2132
Article Number: 62
Copyright: © Gao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

A simple and safe triangle‑valve technique (TVT) was applied in proximal gastrectomy (PG) in order to prevent postoperative gastric reflux among patients with adenocarcinoma of the esophagogastric junction (AEG). The clinical outcomes were evaluated in comparison to those of canonical total gastrectomy (TG). This retrospective study of 74 AEG patients compared two surgical procedures, PG‑TVT (n=44) and TG (n=30), in terms of surgical outcomes, postoperative complications and nutritional status. The Reflux Disease Questionnaire (RDQ) was used to evaluate reflux esophagitis, and patients with an RDQ score of ≥12 points were diagnosed with gastroesophageal reflux disease (GERD). The mean operative time was significantly shorter in the PG‑TVT group (242.6 min) compared with that in the TG group (288.1 min). The overall postoperative complication rate did not differ significantly between the PG‑TVT and TG groups. All the patients were followed up for 6 months, and none developed cancer recurrence in distant organs, gastric remnant, or lymph nodes. The GERD incidence was similar between the PG‑TVT and TG groups. The mean levels of total protein and albumin within 6 months were significantly higher in the PG‑TVT group compared with those in the TG group after adjustingtthe time effect and the interaction of time and surgical methods. The level of total protein significantly increased within 6 months in the PG‑TVT group, but decreased in the TG group. Therefore, PG‑TVT has several advantages over TG for patients with AEG, including a shorter operative time and better postoperative nutritional status, whereas the incidence of GERD was found to be similar between the two techniques.

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