ArticleLangenbeck's archives of surgery2019
Comparison of double-flap and OrVil techniques of laparoscopy-assisted proximal gastrectomy in preventing gastroesophageal reflux: a retrospective cohort study.
Article in Langenbeck's archives of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Comparison on the reflux and nutritional status of different reconstruction methods after laparoscopic proximal gastrectomy: a systematic review and network meta-analysis.Updates in surgery · 2026Pooled it
- Clinical Outcomes According to Surgical Strategies in Proximal Early Gastric Cancer: A Systematic Review and Network Meta-Analysis.Journal of gastric cancer · 2025Pooled it
- Postoperative nutritional outcomes and quality of life-related complications of proximal versus total gastrectomy for upper-third early gastric cancer: a meta-analysis.Scientific reports · 2020Pooled it
- Functional Outcomes and Anti-Reflux Performance of Reconstruction Methods Following Proximal Gastrectomy: A Systematic Review.Cancers · 2026Review
- Risk Factors for Anastomotic Stricture and Obstructive Symptoms Following Double-Flap Technique Reconstruction After Proximal Gastrectomy.Annals of gastroenterological surgery · 2026Article
- Applications on proximal gastrectomy with gastroesophageal muscular flap anastomosis in laparoscopic surgery: a narrative review.BMC surgery · 2026Review
- Kamikawa anastomosis in proximal gastrectomy for gastric cancer: A systematic review and meta-analysis.World journal of gastrointestinal surgery · 2025Article
- German guidelines for the diagnosis and treatment of squamous-cell carcinoma and adenocarcinoma of the esophagus-version 4.0.ESMO gastrointestinal oncology · 2025Review
- Digestive tract reconstruction after laparoscopic proximal gastrectomy: Double tract reconstruction or double flap technique?Annals of gastroenterological surgery · 2025Article
- Safety of robotic double-flap technique following proximal gastrectomy in the introductory phase compared with laparoscopic procedure: a propensity score-matched analysis.Surgical endoscopy · 2024Article
- Safety and short-term outcomes of a modified valvuloplastic esophagogastrostomy versus gastric tube anastomosis after laparoscopy-assisted proximal gastrectomy: a retrospective cohort study.Surgical endoscopy · 2024Article
- Nutritional care in patients undergoing laparoscopic/minimally invasive surgeries for gastrointestinal tumours.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2023Review
- A Novel Surgical Technique for Double Flap Reconstruction Using a Circular Stapler After Laparoscopic Proximal Gastrectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Review
- Anastomotic stenosis following proximal gastrectomy with single flap valvulopasty successfully managed with endoscopic stricturotomy: a case report.Frontiers in surgery · 2023Article
- Simple modifications of conventional esophagogastrostomy after proximal gastrectomy adequately reduces the postoperative reflux esophagitis: a retrospective analysis of posterolateral fundoplication.Langenbeck's archives of surgery · 2022Article
- Modified side overlap esophagogastrostomy after laparoscopic proximal gastrectomy.Annals of gastroenterological surgery · 2022Article
- Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2021.Journal of gastroenterology · 2022Review
- Study protocol for comparing the efficacy of left-open single-flap technique versus double-flap technique after proximal gastrectomy: A multicenter randomized controlled trial.Frontiers in oncology · 2022Article
- Is proximal gastrectomy indicated for locally advanced cancer in the upper third of the stomach?Annals of gastroenterological surgery · 2021Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopy-assisted proximal gastrectomy (LAPG) with esophagogastrostomy using the double-flap technique has been reported to rarely cause gastroesophageal reflux. However, quantitative evaluation of the reflux has hardly been performed. The aim of this study was to clarify the superiority of the double-flap technique of LAPG with esophagogastrostomy compared with the OrVil technique in terms of preventing gastroesophageal reflux.
methodsA total of 40 and 51 patients who underwent LAPG with esophagogastrostomy using the double-flap and OrVil techniques, respectively, for upper one-third gastric cancer were included in this study. Of these, 22 and 13 patients in the double-flap and OrVil groups, respectively, consented to undergo a 24-h impedance-pH monitoring test at 3 months postoperatively. Postoperative complications, including gastroesophageal reflux and anastomotic stricture, were assessed retrospectively.
resultsNo significant differences were observed in the patients' background between both groups, except for a higher D1+ dissection rate observed in double-flap group than in the OrVil group (93% vs 25%, P < 0.001). Operative time was significantly longer in the double-flap group than in the OrVil group (353 min vs 280 min, P < 0.001). All reflux % time was significantly lower in the double-flap group than in the OrVil group (1.29% vs 2.62%, P = 0.043). On the other hand, the proportion of anastomotic stricture requiring endoscopic balloon dilatation was lower in the double-flap group than in the OrVil group but without statistical significance (18% vs 27%; P = 0.32).
conclusionsDespite its longer operative time and still relatively high anastomotic stricture rate, the double-flap technique would be better than the OrVil technique in terms of preventing gastroesophageal reflux in patients who underwent LAPG with esophagogastrostomy.
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