Lower Esophageal Sphincter-preserving Anastomosis Is an Acceptable Reconstruction Method Following Laparoscopy-assisted Proximal Gastrectomy

Abstract

Background/Aims: Our study aimed to compared 3-year results following laparoscopy-assisted proximal gastrectomy (LAPG)-double tract anastomosis (DTA) and lower esophageal sphincter-preserving LAPG (LES-LAPG). Patients and Methods: Nine patients who underwent LES-LAPG and 23 LAPG-DTA were compared regarding 3-year follow-up complications, the anemia-related parameter and albumin levels. Results: During the 3-year follow-up period, no patient (0%) in the LES-LAPG and six patients (6/23, 26.1%) in the LAPG-DTA group developed reflux symptoms. Reflux symptoms were well controlled with PPI in all patients, except for one in the LAPG-DTA group. In the laboratory study, there were no differences in serum ferritin and vitamin B12 levels between the two groups. However, mean hemoglobin and albumin levels were significantly higher in the LES-LAPG group from 18 months postoperatively. Conclusion: LES-LAPG provided acceptable results for the prevention of reflux esophagitis. Moreover, LES-LAPG may be advantageous for anemia prevention and nutritional status improvement compared to LAPG-DTA.