Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 113-123
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.113
Clinical efficacy of modified Kamikawa anastomosis in patients with laparoscopic proximal gastrectomy
Chu-Ying Wu, Jian-An Lin, Kai Ye
Chu-Ying Wu, Jian-An Lin, Kai Ye, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
Co-first authors: Chu-Ying Wu and Jian-An Lin.
Author contributions: Wu CY and Lin JA contributed equally to the study; Wu CY contributed to data curation, original draft preparation, project administration, and funding acquisition; Lin JA contributed to software, writing, review, and editing; Kai Y contributed to conceptualization, supervision, and funding acquisition; all authors have read and agreed to the published version of the manuscript.
Supported by the Fujian Medical University Sailing Fund General Project, No. 2022QH1117; and Key Clinical Specialty Discipline Construction Program of Fujian, Fujian Health Medicine and Politics, No. [2022]884.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Second Affiliated Hospital of Fujian Medical University (Approval No. 2022219).
Informed consent statement: The requirement for informed consent was waived by the Ethics Committee considering the retrospective design of the study.
Conflict-of-interest statement: All authors report no conflicts of interest.
Data sharing statement: The datasets that were used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
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: Kai Ye, MD, Chief Doctor, Dean, Professor, Research Dean, Surgeon, Surgical Oncologist, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, No. 950 Donghai Street, Quanzhou 362000, Fujian Province, China. medwcy@163.com
Received: October 12, 2023
Peer-review started: October 12, 2023
First decision: December 15, 2023
Revised: December 20, 2023
Accepted: January 10, 2024
Article in press: January 10, 2024
Published online: January 27, 2024
Processing time: 104 Days and 16.6 Hours
Abstract
BACKGROUND

With the increasing incidence of proximal gastric cancer, laparoscopic proximal gastrectomy has been applied. However, reflux esophagitis often occurs after traditional esophagogastric anastomosis. In order to solve this problem, several methods of digestive tract reconstruction have emerged, but the most satisfying method remains to be discussed. Therefore, we modified traditional Kamikawa anastomosis to investigate the appropriate digestive tract reconstruction in laparoscopic proximal gastrectomy.

AIM

To discuss the clinical efficacy of modified Kamikawa anastomosis in laparoscopic proximal gastrectomy.

METHODS

A retrospective case series was adopted. Clinicopathological data were collected from 26 patients who underwent laparoscopic proximal gastrectomy and modified Kamikawa anastomosis at our hospital from January 2020 to September 2022. The operation conditions, postoperative recovery, postoperative complications, and follow-up data were collected and analyzed.

RESULTS

All the patients were successfully operated on without conversion to laparotomy. The duration of operation and digestive tract reconstruction were 203.500 (150-224) min and 87.500 (73-111) min, respectively. The intraoperative amount of bleeding was 20.500 mL ± 0.696 mL. The time of postoperative first flatus, the first postoperative fluid intake, and the postoperative length of stay were 2 (1-3) d, 4 (3-5) d, and 9 (8-10) d, respectively. All the patients were followed up for 12-23 months. The body mass index at 6 and 12 months after surgery were 22.577 kg/m2 ± 3.098 kg/m2 and 22.594 kg/m2 ± 3.207 kg/m2, respectively. The nutrition risk screening 2002 score, the patient-generated subjective global assessment score, and the gastroesophageal reflux disease scale score were good at 6 and 12 months after surgery. Reflux esophagitis and anastomotic stenosis were not observed in any of the patients during their 12-month postoperative gastroscopy or upper gastrointestinal tract visits. All the patients exhibited no tumor recurrence or metastasis.

CONCLUSION

The modified Kamikawa anastomosis is safe and feasible for laparoscopic proximal gastrectomy and has good antireflux effects and nutritional status.

Keywords: Modified Kamikawa anastomosis; Laparoscopy; Proximal gastrectomy; Antireflux

Core Tip: The study retrospectively analyzed clinicopathological data of patients who underwent laparoscopic proximal gastrectomy and modified Kamikawa anastomosis. According to our research, modified Kamikawa anastomosis in laparoscopic proximal gastrectomy is safe, feasible and shows good antireflux effect.