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The feasibility of vagus nerve preservation and double-flap technique in laparoscopic proximal gastrectomy
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  • Ke-kang SUN,
  • Zhen WANG,
  • Wei PENG,
  • Ming CHENG,
  • zheng-rong CHEN,
  • rui REN,
  • qiang CHEN,
  • Yong-you WU
Ke-kang SUN
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Ming CHENG
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zheng-rong CHEN
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qiang CHEN
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Yong-you WU
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Abstract

Background: Laparoscopic proximal gastrectomy with an anti-reflux procedure, as a function-preserving surgery, has been a common treatment strategy for proximal early gastric cancer. This study aimed to develop a new surgical technique for these patients. Methods: Laparoscopic proximal gastrectomy with vagus nerve preservation and double-flap technique was performed in patients who could retain two-thirds of the stomach. The hepatic branches and the celiac branches were both preserved. A seromuscular double-flap was created through the auxiliary incision, and the anastomosis was performed under laparoscopy. The detailed surgical procedure and preliminary results were presented. Results: Six patients underwent this procedure with no conversion to open surgery. No intraoperative and postoperative complications occurred during the perioperative period. No patients showed diarrhea and appetite loss, and body weight regained preoperative level 6 month later. No food residue and reflux esophagitis were observed via endoscopic examination. Gallbladder contraction was observed in all the patients by ultrasonography after high-fat diet. Conclusion: Although long-term follow up and a larger number of patients are required to evaluate the functional outcomes, this new technique provides a minimally invasive surgical option for proximal early gastric cancer, especially in the cardiac area.

Peer review status:UNDER REVIEW

07 May 2021Submitted to International Journal of Clinical Practice
07 May 2021Assigned to Editor
07 May 2021Submission Checks Completed
08 May 2021Reviewer(s) Assigned