Scholarlink

Background <p>The debate over the optimal reconstruction technique following proximal gastrectomy continues. Transhiatal tunnel valvuloplasty (ThTV) is a novel esophagogastrostomy method. This study aimed to evaluate the feasibility and safety of ThTV.</p> Methods <p>A cohort with upper early gastric cancer or Siewert type II tumors who underwent laparoscopic proximal gastrectomy was retrospectively reviewed in a single center. The ThTV esophagogastrostomy procedure involved placing a lengthy gastric tube into the lower mediastinum and firmly binding it to the esophagus. Demographic and surgical morbidity data were extracted from the medical records.</p> Results <p>Between March 2023 and November 2023, 15 patients underwent laparoscopic proximal gastrectomy using ThTV. The cohort consisted of 13 males and 2 females, with a median age of 68 years (range 49-77). The median operative time was 213 minutes (range 171-370). The median times for tunnel construction and anastomosis were 7 minutes (range 4-30) and 17 minutes (range 10-29), respectively. The median tumor size was 2.0 cm (range 1.0-5.0), and the median number of lymph nodes dissected was 29 (range 13-49). TNM staging revealed 9 cases of stage I, 5 cases of stage II, and 1 case of stage III. As of January 1, 2025, the median follow-up duration was 16.8 months (range 13.8-22.2). No tumor recurrence was observed. No patients reported severe reflux symptoms (Visick score ≥III). Gastroscopy confirmed reflux esophagitis (Los Angeles classification Grade A) in one patient, and an anastomotic stricture requiring endoscopic balloon dilation was observed in another patient.</p> Conclusions <p>Transhiatal tunnel valvuloplasty is a simple and reliable anti-reflux method following laparoscopic proximal gastric surgery. The further verification of the esophageal function is warranted.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The transhiatal tunnel valvuloplasty technique following laparoscopic proximal gastrectomy: the single-center experience in a retrospective cohort

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年4月8日

查看全文
  • Chunguang Guo,
  • Zefeng Li,
  • Xin Guo,
  • Yong Liu,
  • Dong Qu,
  • Zhaodong Xing,
  • Hu Ren,
  • Chongyuan Sun,
  • He Fei,
  • Xiaojie Zhang,
  • Lei Ge,
  • Yanwei Gao,
  • Enjun Li,
  • Chaodong Yin,
  • Jing Zhang,
  • Guiqi Wang,
  • Dongbing Zhao

摘要

Background

The debate over the optimal reconstruction technique following proximal gastrectomy continues. Transhiatal tunnel valvuloplasty (ThTV) is a novel esophagogastrostomy method. This study aimed to evaluate the feasibility and safety of ThTV.

Methods

A cohort with upper early gastric cancer or Siewert type II tumors who underwent laparoscopic proximal gastrectomy was retrospectively reviewed in a single center. The ThTV esophagogastrostomy procedure involved placing a lengthy gastric tube into the lower mediastinum and firmly binding it to the esophagus. Demographic and surgical morbidity data were extracted from the medical records.

Results

Between March 2023 and November 2023, 15 patients underwent laparoscopic proximal gastrectomy using ThTV. The cohort consisted of 13 males and 2 females, with a median age of 68 years (range 49-77). The median operative time was 213 minutes (range 171-370). The median times for tunnel construction and anastomosis were 7 minutes (range 4-30) and 17 minutes (range 10-29), respectively. The median tumor size was 2.0 cm (range 1.0-5.0), and the median number of lymph nodes dissected was 29 (range 13-49). TNM staging revealed 9 cases of stage I, 5 cases of stage II, and 1 case of stage III. As of January 1, 2025, the median follow-up duration was 16.8 months (range 13.8-22.2). No tumor recurrence was observed. No patients reported severe reflux symptoms (Visick score ≥III). Gastroscopy confirmed reflux esophagitis (Los Angeles classification Grade A) in one patient, and an anastomotic stricture requiring endoscopic balloon dilation was observed in another patient.

Conclusions

Transhiatal tunnel valvuloplasty is a simple and reliable anti-reflux method following laparoscopic proximal gastric surgery. The further verification of the esophageal function is warranted.