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Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy

PURPOSE: Various reconstruction methods have been proposed to reduce reflux after proximal gastrectomy, and we report here a double shouldering technique. The purpose of this study is to compare the novel double shouldering technique with conventional esophagogastrostomy in terms of short term and 3...

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Autores principales: Kim, Min Chul, Yehuda, Amir Ben, Kim, Young-Woo, Yoon, Hong Man, Khalayleh, Harbi, Han, Won Ho, Noshiro, Hirokazu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Endoscopic and Laparoscopic Surgeons 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8985637/
https://www.ncbi.nlm.nih.gov/pubmed/35601637
http://dx.doi.org/10.7602/jmis.2020.23.4.191
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author Kim, Min Chul
Yehuda, Amir Ben
Kim, Young-Woo
Yoon, Hong Man
Khalayleh, Harbi
Han, Won Ho
Noshiro, Hirokazu
author_facet Kim, Min Chul
Yehuda, Amir Ben
Kim, Young-Woo
Yoon, Hong Man
Khalayleh, Harbi
Han, Won Ho
Noshiro, Hirokazu
author_sort Kim, Min Chul
collection PubMed
description PURPOSE: Various reconstruction methods have been proposed to reduce reflux after proximal gastrectomy, and we report here a double shouldering technique. The purpose of this study is to compare the novel double shouldering technique with conventional esophagogastrostomy in terms of short term and 3-year clinical outcome. METHODS: A retrospective observational case control study was performed on 63 patients for cT1N0 upper third gastric cancer who underwent proximal gastrectomy from January 2012 to November 2016 at the National Cancer Center, Korea. There were 26 patients with conventional esophagogastrostomy, and 37 patients with novel double shouldering technique. The primary outcome was endoscopic reflux esophagitis findings one and three year after surgery according to Los Angeles classification. Secondary outcomes were short term surgical outcome and reflux symptom. RESULTS: There was no significant difference in reflux esophagitis on endoscopic findings at 1 and 3 years after surgery between the two group. The double shouldering (DS) technique group showed significantly better postoperative outcomes with bile reflux at one and three years via endoscopic findings versus conventional esophagogastrostomy (CEG). Operative time and hospital stay were significantly shorter in the CEG group than the DS group. There was no significant difference in terms of reflux symptoms and complications. CONCLUSION: This novel DS technique is a reconstruction method for use after proximal gastrectomy. It did not show a significant clinical benefit. Development of surgical techniques and further study is needed to identify the optimal reconstruction method after proximal gastrectomy.
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spelling pubmed-89856372022-05-19 Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy Kim, Min Chul Yehuda, Amir Ben Kim, Young-Woo Yoon, Hong Man Khalayleh, Harbi Han, Won Ho Noshiro, Hirokazu J Minim Invasive Surg Original Article PURPOSE: Various reconstruction methods have been proposed to reduce reflux after proximal gastrectomy, and we report here a double shouldering technique. The purpose of this study is to compare the novel double shouldering technique with conventional esophagogastrostomy in terms of short term and 3-year clinical outcome. METHODS: A retrospective observational case control study was performed on 63 patients for cT1N0 upper third gastric cancer who underwent proximal gastrectomy from January 2012 to November 2016 at the National Cancer Center, Korea. There were 26 patients with conventional esophagogastrostomy, and 37 patients with novel double shouldering technique. The primary outcome was endoscopic reflux esophagitis findings one and three year after surgery according to Los Angeles classification. Secondary outcomes were short term surgical outcome and reflux symptom. RESULTS: There was no significant difference in reflux esophagitis on endoscopic findings at 1 and 3 years after surgery between the two group. The double shouldering (DS) technique group showed significantly better postoperative outcomes with bile reflux at one and three years via endoscopic findings versus conventional esophagogastrostomy (CEG). Operative time and hospital stay were significantly shorter in the CEG group than the DS group. There was no significant difference in terms of reflux symptoms and complications. CONCLUSION: This novel DS technique is a reconstruction method for use after proximal gastrectomy. It did not show a significant clinical benefit. Development of surgical techniques and further study is needed to identify the optimal reconstruction method after proximal gastrectomy. The Korean Society of Endoscopic and Laparoscopic Surgeons 2020-12-15 2020-12-15 /pmc/articles/PMC8985637/ /pubmed/35601637 http://dx.doi.org/10.7602/jmis.2020.23.4.191 Text en Copyright © 2020 The Journal of Minimally Invasive Surgery. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Min Chul
Yehuda, Amir Ben
Kim, Young-Woo
Yoon, Hong Man
Khalayleh, Harbi
Han, Won Ho
Noshiro, Hirokazu
Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy
title Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy
title_full Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy
title_fullStr Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy
title_full_unstemmed Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy
title_short Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy
title_sort clinical outcome of novel reconstruction of double shouldering technique after proximal gastrectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8985637/
https://www.ncbi.nlm.nih.gov/pubmed/35601637
http://dx.doi.org/10.7602/jmis.2020.23.4.191
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