Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.2003
Peer-review started: June 30, 2023
First decision: July 18, 2023
Revised: July 24, 2023
Accepted: August 8, 2023
Article in press: August 8, 2023
Published online: September 27, 2023
Esophageal gastric anastomosis is a common surgical technique used in the treatment of gastric cancer patients undergoing total gastrectomy. However, complications such as anastomotic stenosis and ulceration can arise when simple anastomosis techniques are used alone, which may not adequately meet patient needs. To address these issues and improve patient prognosis, the muscle flap reconstruction technique has emerged. Muscle flap reconstruction involves transplanting muscle tissue to enhance gastric-esophageal anastomosis. By covering the anastomotic site with muscle tissue, it not only improves stability but also enhances blood supply, promoting healing and recovery. Therefore, the application of muscle flap reconstruction in esophageal gastric anastomosis during total gastrectomy for gastric cancer is increasingly widespread.
Gastric cancer is a significant health concern, and total gastrectomy is a common surgical treatment for this condition. However, traditional esophagogastric anastomosis techniques have limitations, leading to complications and suboptimal patient outcomes. The emergence of muscle flap reconstruction technique provides a potential solution to overcome these challenges. By transplanting muscle tissue, the technique improves the stability and blood supply of the anastomosis site, promoting healing and recovery.
The objective of this study was to evaluate the effect of esophagogastrostomy with muscle flap reconstruction technique on the prognosis of patients undergoing total gastrectomy for gastric cancer.
This study included 60 patients with gastric cancer who underwent total abdominal gastrectomy with esophagogastric anastomosis using double muscle flap reconstruction technique. Perioperative indicators, such as operation time, formation time of esophageal double muscle flap anastomosis, number of lymph node dissections, incision length, intraoperative bleeding volume, were recorded. Patients were followed up for one year to observe outcomes and classify patients based on different outcomes. Clinicopathological parameters were analyzed to identify factors affecting patient prognosis.
The study involved 60 patients with gastric cancer who underwent total abdominal gastrectomy with esophagogastric anastomosis using double muscle flap reconstruction technique. The operation time averaged (318 ± 43 min), formation time of esophageal double muscle flap anastomosis was (110 ± 13 min), and other perioperative indicators were measured. Three postoperative complications were recorded: 2 cases of pulmonary infection and 1 case of respiratory discomfort. During the one-year follow-up, 50 patients survived while 10 died. Univariate analysis identified histological types, tumor size, tumor-node-metastasis staging, vascular invasion, and postoperative adjuvant radiotherapy and chemotherapy as the main factors affecting prognosis in surviving patients. Cox regression analysis confirmed the significance of postoperative adjuvant therapy on patient prognosis. The survival time of the survival group was signi
The study concludes that esophagogastric anastomosis with muscle flap reconstruction is effective for patients undergoing total abdominal gastrectomy for gastric cancer. The technique improves the stability of the anastomosis site and enhances blood supply, promoting healing and recovery. Esophagogastric anastomosis with muscle flap recon
Future research can focus on optimizing the muscle flap reconstruction technique to further enhance surgical outcomes and minimize complications. Additionally, investigating the long-term effects of postoperative adjuvant radiotherapy and chemotherapy on patient prognosis would provide valuable insights. Furthermore, evaluating the cost-effectiveness of this technique and comparing it with other surgical methods will help guide decision-making in clinical practice.