ArticleSurgical endoscopy2024
Safety and short-term outcomes of a modified valvuloplastic esophagogastrostomy versus gastric tube anastomosis after laparoscopy-assisted proximal gastrectomy: a retrospective cohort study.
Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.
- Comparison of postoperative reflux esophagitis in different digestive tract reconstruction methods after proximal gastrectomy for proximal gastric cancer patients: a network meta-analysis and systematic review.Updates in surgery · 2026Pooled it
- Pooled it
- Short-term outcomes of a novel anti-reflux biologic flap technique versus double flap technique after laparoscopic proximal gastrectomy: a retrospective cohort study.Surgical endoscopy · 2026Article
- Surgical safety and technical optimization of arch-bridge anastomosis after laparoscopy-assisted proximal gastrectomy: An IDEAL stage 2a prospective cohort study.Chinese medical journal · 2026Article
- Kamikawa anastomosis in proximal gastrectomy for gastric cancer: A systematic review and meta-analysis.World journal of gastrointestinal surgery · 2025Article
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Authors and funding
13 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundThere is no optimal reconstruction method after proximal gastrectomy. The valvuloplastic esophagogastrostomy can reduce postoperative reflux esophagitis, but it is technically complex with a long operation time. The gastric tube anastomosis is technically simple, but the incidences of reflux esophagitis and anastomotic stricture are higher.
methodsWe have devised a modified valvuloplastic esophagogastrostomy after laparoscopy-assisted proximal gastrectomy (LAPG), the arch-bridge anastomosis. After reviewing our prospectively maintained gastric cancer database, 43 patients who underwent LAPG from November 2021 to April 2023 were included in this cohort study, with 25 patients received the arch-bridge anastomosis and 18 patients received gastric tube anastomosis. The short-term outcomes were compared between the two groups to evaluate the efficacy of the arch-bridge anastomosis. Reporting was consistent with the STROCSS 2021 guideline.
resultsThe median operation time was 180 min in the arch-bridge group, significantly shorter than the gastric tube group (p = 0.003). In the arch-bridge group, none of the 25 patients experienced anastomotic leakage, while one patient (4%) experienced anastomotic stricture requiring endoscopic balloon dilation. The postoperative length of stay was shorter in the arch-bridge group (9 vs. 11, p = 0.034). None of the patients in the arch-bridge group experienced gastroesophageal reflux and used proton pump inhibitor (PPI), while four (22.2%) patients in the gastric tube group used PPI (p = 0.025). The incidence of reflux esophagitis (Los Angeles grade B or more severe) by endoscopy was lower in the arch-bridge group (0% vs. 25.0%).
conclusionThe arch-bridge anastomosis is a safe, time-saving, and feasible reconstruction method. It can reduce postoperative reflux and anastomotic stricture incidences in a selected cohort of patients undergoing laparoscopy-assisted proximal gastrectomy.
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