Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.100799
Revised: December 10, 2024
Accepted: January 6, 2025
Published online: March 27, 2025
Processing time: 181 Days and 20 Hours
Proximal gastrectomy for gastric cancer often leads to postoperative gastroesophageal reflux (GER). This study compares the impact of forearm anastomosis and posterior wall anastomosis techniques on GER in patients undergoing this procedure.
To identify the most effective method for reducing reflux symptoms while preserving gastrointestinal integrity and nutritional status.
A retrospective evaluation was conducted on 60 patients who underwent proximal gastrectomy between December 2020 and December 2023, divided equally into two groups based on the anastomosis technique used (forearm or posterior wall). GER symptoms were assessed using the GER disease ques
Both groups showed significant improvements in GerdQ scores and reflux symptom scores post-treatment, with the observation group exhibiting greater reductions. Biochemical markers indicated enhanced gastrointestinal barrier function post-treatment in both groups, with notable increases in DAO, D-lactic, and ETX levels. Nutritional status indicators also demonstrated significant changes, with reductions in SF, PA, and ALB levels, suggesting an impact of treatment on inflammatory and nutritional status.
The forearm anastomosis technique appears to be more effective in reducing GER symptoms and preserving gastrointestinal health in patients undergoing proximal gastrectomy for gastric cancer compared to the posterior wall anastomosis technique. These preliminary findings advocate for further research to confirm the benefits and potentially standardize Forearm Anastomosis in surgical practice for gastric cancer.
Core Tip: This manuscript provides a comprehensive analysis of two distinct anastomosis techniques and their effects on postoperative gastroesophageal reflux (GER), an issue of paramount importance in the surgical management of gastric cancer. Our study embarked on a meticulous comparative evaluation between forearm anastomosis and posterior wall anastomosis techniques, focusing on their efficacy in mitigating GER symptoms and their impact on the gastrointestinal barrier function and nutritional status of the patient’s post-proximal gastrectomy. Through rigorous assessment and detailed analysis, our findings illuminate the superior benefits of the Forearm Anastomosis technique, not only in reducing GER symptoms but also in preserving gastrointestinal health.