Effect of forearm and posterior wall anastomosis on gastroesophageal reflux in proximal gastrectomy patients  

作　　者：Jia-Le Yang Yi-Jie Yang Lu Xu 

机构地区：[1]Department of General Surgery,The First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2025年第3期213-220,共8页世界胃肠外科杂志(英文)

摘　　要：BACKGROUND Proximal gastrectomy for gastric cancer often leads to postoperative gastroeso-phageal reflux(GER).This study compares the impact of forearm anastomosis and posterior wall anastomosis techniques on GER in patients undergoing this procedure.AIM To identify the most effective method for reducing reflux symptoms while preserving gastrointestinal integrity and nutritional status.METHODS 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-tionnaire(GerdQ)preoperatively and on the first postoperative day.Biochemical markers[diamine oxidase(DAO),D-lactic acid,and endotoxin(ETX)]and nutritional indicators[serum ferritin(SF),prealbumin(PA),and albumin(ALB)]were measured to evaluate gastrointestinal barrier function and nutritional status.RESULTS 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.CONCLUSION 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.

关 键 词：Proximal gastrectomy Gastroesophageal reflux Forearm anastomosis Posterior wall anastomosis Gastric cancer 

分 类 号：R735.2[医药卫生—肿瘤]