Technical variety of anastomotic techniques used in proximal gastrectomy with double-tract-reconstruction - a narrative review

• Published in: Langenbeck's archives of surgery Vol. 409; no. 1; p. 148
• Main Authors: Tang, Hai-Peng, Zhu, He-Xi, Lu, Guo-Peng, Peng, Zheng-Qi, Chen, Ze-Kai, Wang, Meng-Chuan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 02.05.2024
• Subjects: Abdominal Surgery; Anastomosis, Surgical - methods; Cardiac Surgery; Esophagogastric Junction - surgery; Gastrectomy - methods; General Surgery; Humans; Jejunum - surgery; Medicine; Medicine & Public Health; Plastic Surgery Procedures - methods; Review; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgical Flaps; Thoracic Surgery; Traumatic Surgery; Vascular Surgery; Esophagogastric junction cancer; Proximal gastrectomy; Double tract reconstruction
• ISSN: 1435-2451; 1435-2451
• DOI: 10.1007/s00423-024-03339-3

In the past 40 years, the incidence of esophagogastric junction cancer has been gradually increasing worldwide. Currently, surgical resection remains the main radical treatment for early gastric cancer. Due to the rise of functional preservation surgery, proximal gastrectomy has become an alternative to total gastrectomy for surgeons in Japan and South Korea. However, the methods of digestive tract reconstruction after proximal gastrectomy have not been fully unified. At present, the principal methods include esophagogastrostomy, double flap technique, jejunal interposition, and double tract reconstruction. Related studies have shown that double tract reconstruction has a good anti-reflux effect and improves postoperative nutritional prognosis, and it is expected to become a standard digestive tract reconstruction method after proximal gastrectomy. However, the optimal anastomoses mode in current double tract reconstruction is still controversial. This article aims to review the current status of double tract reconstruction and address the aforementioned issues.