1. General Surgery, Cancer Center, Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang 310014, China.
2. Key Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
3. Department of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, jinan 250013, China.
4. Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China.
Proximal gastrectomy is more frequently recommended for early upper gastric cancer and Siewert II gastroesophageal junction cancer less than 4 cm in length. After proximal gastrectomy, the anatomical structure of the gastroesophageal junction can be destroyed, and the anti-reflux effect of the cardia is lost. In recent years, as various anti-reflux reconstructions have been developed, some functions of the stomach are retained, and serious reflux esophagitis is avoided after proximal gastrectomy. In this article, we summarized the indications, advantages, and disadvantages of various classic reconstruction and latest improved reconstruction method including esophageal and residual stomach anastomosis, tubular gastroesophageal anastomosis, muscle flap anastomosis, jejunal interposition, and double-tract reconstruction.
Keywords: proximal gastrectomy, gastroesophageal anastomosis, muscle flap anastomosis, jejunal interposition, double-tract reconstruction