Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2025; 17(1): 101204
Published online Jan 27, 2025. doi: 10.4240/wjgs.v17.i1.101204
Comparative study of clinical efficacy of laparoscopic proximal gastrectomy with double-channel anastomosis and tubular gastroesophageal anastomosis
Mian Wang, Li-Li Zhang, Gang Wang, Yong-Chang Miao, Tao Zhang, Lei Qiu, Gui-Da Fang, Feng Lu, Da-Lai Xu, Peng Yu
Mian Wang, Department of Nail and Breast Surgery, The Second People’s Hospital of Lianyungang, Lianyungang 222000, Jiangsu Province, China
Li-Li Zhang, Department of Emergency Medicine, Lianyungang Second People’s Hospital, Lianyungang 222000, Jiangsu Province, China
Gang Wang, Yong-Chang Miao, Tao Zhang, Lei Qiu, Gui-Da Fang, Feng Lu, Da-Lai Xu, Peng Yu, Department of Gastrointestinal Surgery, The Second People’s Hospital of Lianyungang, Lianyungang 222000, Jiangsu Province, China
Co-first authors: Mian Wang and Li-Li Zhang.
Co-corresponding authors: Gang Wang and Yong-Chang Miao.
Author contributions: Zhang LL, Qiu L, Wang M, and Zhang T conceived, designed, and refined the study protocol; Zhang LL, Wang M, and Xu DL acquired and analyzed the data; Qiu T and Zhang T wrote the manuscript; Fang GD, Yu P, and Lu F contributed to the data analyses; Wang G provided clinical advice; Wang G and Miao YC supervised the report and provided the funding acquisition; and all authors have read and approved the final version. Zhang LL and Wang M contributed equally to this work as co-first authors; Wang G and Miao YC contributed equally to this work as co-corresponding authors. There are two reasons for this designation. First, the research was performed as a collaborative effort, and the designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper’s quality and reliability. Second, Zhang LL and Wang M contributed efforts of equal substance throughout the research process. The choice of these researchers as co-first authors acknowledges and respects this equal contribution while recognizing the spirit of teamwork and collaboration in this study. In summary, we believe that designating Zhang LL and Wang M as co-first authors/Wang G and Miao YC as co-corresponding authors is appropriate for our manuscript, as it accurately reflects our team’s collaborative spirit, equal contributions, and diversity.
Supported by the “521 Project” Funding Project Day of Lianyungang.
Institutional review board statement: This study was reviewed and approved by the Second People’s Hospital of Lianyungang (approval No. 2024k035).
Informed consent statement: Data was de-identified and retrospectively collected, and therefore informed consent was not required from each patient.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: Dataset available from the corresponding author at lygeymyc@163com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Chang Miao, Department of Gastrointestinal Surgery, The Second People’s Hospital of Lianyungang, No. 41 Hailian East Road, Lianyungang 222000, Jiangsu Province, China. lygeymyc@163.com
Received: September 9, 2024
Revised: October 6, 2024
Accepted: November 1, 2024
Published online: January 27, 2025
Processing time: 109 Days and 0 Hours
Abstract
BACKGROUND

According to statistics, the incidence of proximal gastric cancer has gradually increased in recent years, posing a serious threat to human health. Tubular gastroesophageal anastomosis and double-channel anastomosis are two relatively mature anti-reflux procedures. A comparison of these two surgical procedures, tubular gastroesophageal anastomosis and double-channel anastomosis, has rarely been reported. Therefore, this study aimed to investigate the effects of these two reconstruction methods on the quality of life of patients with proximal gastric cancer after proximal gastrectomy.

AIM

To compare short-term clinical results of laparoscopic proximal gastrectomy with double-channel anastomosis vs tubular gastric anastomosis.

METHODS

Patients who underwent proximal gastrectomy at our hospital between January 2020 and January 2023 were enrolled in this retrospective cohort study. The patients were divided into an experimental group (double-channel anastomosis, 33 cases) and a control group (tubular gastric anastomosis, 30 cases). Baseline characteristics, surgical data, postoperative morbidities, and postoperative nutrition were recorded.

RESULTS

The differences in baseline data, surgical data, and postoperative complications (20.0% vs 21.2%) were not statistically significant between the two groups. There were no statistically significant differences in the levels of postoperative nutrition indicators between the two groups of patients during the preoperative period and at 3 months postoperatively. In addition, the levels of postoperative nutrition indicators in patients in the experimental group declined significantly less at 6 months and 12 months postoperatively compared with those of the control group (P < 0.05). At 12 months postoperatively, the difference in anastomotic reflux esophagitis between the two groups was statistically significant (P < 0.05) with the experimental group showing less reflux esophagitis.

CONCLUSION

Both double-channel anastomosis and tubular gastric anastomosis after proximal gastrectomy are safe and feasible. Double-channel anastomosis has a better anti-reflux effect and is more beneficial in improving the postoperative nutritional status.

Keywords: Laparoscopic; Gastric cancer; Proximal gastrectomy; Double-channel anastomosis; Tubular gastric anastomosis

Core Tip: Commonly used reconstruction methods for proximal gastrectomy in clinical practice include tubular gastroesophageal anastomosis, double-channel anastomosis, and other digestive tract reconstruction methods. However, there are few studies on the clinical efficacy comparison between proximal gastrectomy with double-channel anastomosis and tubular gastroesophageal anastomosis for early proximal gastric cancer in China. In this study, both tubular gastroesophageal anastomosis and double-channel anastomosis have reliable surgical safety. Compared with tubular gastroesophageal anastomosis, dual-channel anastomosis has a better anti-reflux effect and is more conducive to improving patients’ postoperative nutritional status.