Esophagogastric Reconstruction in Cobra-Head Shape with Toupet-Like Partial Anti-Reflux Technique for Resection of Proximal Gastric Tumors. Experience with Three Cases from a Non-Asian Population — Oak Academic Publishing
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Esophagogastric Reconstruction in Cobra-Head Shape with Toupet-Like Partial Anti-Reflux Technique for Resection of Proximal Gastric Tumors. Experience with Three Cases from a Non-Asian Population
Surgical Oncology, National Cancer Institute (México), Mexico City, Mexico
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Surgical Oncology, National Cancer Institute (México), Mexico City, Mexico
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Surgical Pathology, National Cancer Institute (México), Mexico City, Mexico
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Surgical Oncology, National Cancer Institute (México), Mexico City, Mexico
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Surgical Oncology, National Cancer Institute (México), Mexico City, Mexico
Background: Proximal gastrectomy is a rarely performed procedure but a feasible option in benign tumors and malignant neoplasms in the proximal third of the stomach since novel options of reconstructions are available nowadays with fewer long-term sequels. Methods: Report of three cases of proximal gastric gastrointestinal stromal tumors (GIST), with a description of its presentation, histological characteristics, and follow-up after being treated with proximal gastrectomy with cobra head reconstruction. Results: Case 1: A 62-year-old woman with epigastric pain of four months with endoscopic evidence of a cardia GIST. The surgery was performed without complications. The histopathological report confirmed a fusiform GIST of 3.2 × 3 × 2.5 cm, stage IA. No adjuvant treatment was considered. An esophagogram showed no evidence of reflux and no stenosis, and no disease recurrence after 40-months follow-up. Case 2: A 66-year-old woman with dyspepsia and a palpable tumor in the epigastrium. The surgery was performed without complications. The pathology report confirmed a proximal gastric GIST of 13 × 8 × 7 cm, staged II. She received adjuvant treatment with imatinib for 36 months without recurrence and no reflux or stenosis. Case 3: A 55-year-old woman with intermittent hematemesis and right subscapular pain. The surgery was performed without complications. The histopathological report concluded that a GIST tumor of the cardia, 1.4 × 1.2 cm, staged IA. She was left in observation. At a 6-month follow-up, she does not report dysphagia, reflux, or stenosis, and no locoregional recurrence. Conclusions: Open and laparoscopic proximal gastrectomy is a safe therapeutic option for GIST. Furthermore, the reconstruction of the esophagus-gastro anastomosis in the cobra head after proximal gastrectomy is feasible and secure in our population, with good functional results in a short follow-up.
KeywordsGISTGastric CancerLaparoscopyProximal GastrectomyCobra Head Reconstruction
Ilic, M. and Ilic, I. (2022) Epidemiology of Stomach Cancer. World Journal of Gastroenterology, 28, 1187-1203. https://doi.org/10.3748/wjg.v28.i12.1187
Rawla, P. and Barsouk, A. (2019) Epidemiology of Gastric Cancer: Global Trends, Risk Factors and Prevention. Przeglad Gastroenterologiczny, 14, 26-38. https://doi.org/10.5114/pg.2018.80001
Kumamoto, T., Kurahashi, Y., Niwa, H., Nakanishi, Y., Okumura, K., Ozawa, R., Ishida, Y. and Shinohara, H. (2020) True Esophagogastric Junction Adenocarcinoma: Background of Its Definition and Current Surgical Trends. Surgery Today, 50, 809-814. https://doi.org/10.1007/s00595-019-01843-4
Lv, L., Liang, X., Wu, D., Wang, F., Zhang, Y., Cang, H., Deng, X. and Li, M. (2021) Is Cardia Cancer a Special Type of Gastric Cancer? A Differential Analysis of Early Cardia Cancer and Non-Cardia Cancer. Journal of Cancer, 12, 2385-2394. https://doi.org/10.7150/jca.51433
Yura, M., Yoshikawa, T., Otsuki, S., Yamagata, Y., Morita, S., Katai, H., Nishida, T. and Yoshiaki, T. (2019) Oncological Safety of Proximal Gastrectomy for T2/T3 Proximal Gastric Cancer. Gastric Cancer, 22, 1029-1035. https://doi.org/10.1007/s10120-019-00938-8
Kitano, S., Adachi, Y., Shiraishi, N., Suematsu, T. and Bando, T. (1999) Laparoscopic-Assisted Proximal Gastrectomy for Early Gastric Carcinomas. Surgery Today, 29, 389-391. https://doi.org/10.1007/BF02483072
Adachi, Y., Katsuta, T., Aramaki, M., Morimoto, A., Shiraishi, N. and Kitano, S. (1999) Proximal Gastrectomy and Gastric Tube Reconstruction for Early Cancer of the Gastric Cardia. Digestive Surgery, 16, 468-470. https://doi.org/10.1159/000018771
Lim, K.T. (2017) Surgical Treatment of Gastrointestinal Stromal Tumors of the Stomach: Current Status and Future Perspective. Translational Gastroenterology and Hepatology, 2, Article ID: 104. https://doi.org/10.21037/tgh.2017.12.01
Kong, S.H. and Yang, H.K. (2013) Surgical Treatment of Gastric Gastrointestinal Stromal Tumor. Journal of Gastric Cancer, 13, 3-18. https://doi.org/10.5230/jgc.2013.13.1.3
Yamashita, H., Toyota, K., Kunisaki, C., Seshimo, A., Etoh, T. and Ogawa, R. (2022) Current Status of Selecting Type of Gastrectomy and Reconstruction for Patients with Proximal Gastric Cancer in Japan. Asian Journal of Surgery. https://doi.org/10.1016/j.asjsur.2022.11.069
Nakada, K., Kawashima, Y., Kinami, S., Fukushima, R., Yabusaki, H., Seshimo, A., Hiki, N., Koeda, K., Kano, M., Uenosono, Y., Oshio, A. and Kodera, Y. (2021) Comparison of Effects of Six Main Gastrectomy Procedures on Patients’ Quality of Life Assessed by Postgastrectomy Syndrome Assessment Scale-45. World Journal of Gastrointestinal Surgery, 13, 461-475. https://doi.org/10.4240/wjgs.v13.i5.461
Sugoor, P., Shah, S., Dusane, R., Desouza, A., Goel, M. and Shrikhande, S.V. (2016) Proximal Gastrectomy versus Total Gastrectomy for Proximal Third Gastric Cancer: Total Gastrectomy Is not Always Necessary. Langenbeck’s Archives of Surgery, 401, 687-697. https://doi.org/10.1007/s00423-016-1422-3
Chia, D.K.A., Kim, G., Chang, H.S.Y., Toh, B.C., So, J.B.Y. and Shabbir, A. (2019) Kamikawa Double-Flap Reconstruction after Minimally Invasive Ivor-Lewis Esophagectomy. The Annals of Thoracic Surgery, 108, E57-E59. https://doi.org/10.1016/j.athoracsur.2019.01.077
Ueda, Y., Shiraishi, N., Toujigamori, M., Shiroshita, H., Etoh, T. and Inomata, M. (2016) Laparoscopic Proximal Gastrectomy with Gastric Tube Reconstruction. JSLS: Journal of the Society of Laparoendoscopic & Surgeons, 20, e2016.00046. https://doi.org/10.4293/JSLS.2016.00046
Nunobe, S. and Ida, S. (2020) Current Status of Proximal Gastrectomy for Gastric and Esophagogastric Junctional Cancer: A Review. Annals of Gastroenterological Surgery, 4, 498-504. https://doi.org/10.1002/ags3.12365
Jung, D.H., Ahn, S.H., Park, D.J. and Kim, H.H. (2015) Proximal Gastrectomy for Gastric Cancer. Journal of Gastric Cancer, 15, 77-86. https://doi.org/10.5230/jgc.2015.15.2.77
Namikawa, T., Oki, T., Kitagawa, H., Okabayashi, T., Kobayashi, M. and Hanazaki, K. (2012) Impact of Jejunal Pouch Interposition Reconstruction after Proximal Gastrectomy for Early Gastric Cancer on Quality of Life: Short- and Long-Term Consequences. American Journal of Surgery, 204, 203-209. https://doi.org/10.1016/j.amjsurg.2011.09.035
Tanizawa, Y., Tanabe, K., Kawahira, H., Fujita, J., Takiguchi, N., Takahashi, M., Ito, Y., Mitsumori, N., Namikawa, T., Oshio, A., Nakada, K. and Japan Postgastrectomy Syndrome Working Party (2016) Specific Features of Dumping Syndrome after Various Types of Gastrectomy as Assessed by a Newly Developed Integrated Questionnaire, the PGSAS-45. Digestive Surgery, 33, 94-103. https://doi.org/10.1159/000442217
Son, M.W., Kim, Y.J., Jeong, G.A., Cho, G.S. and Lee, M.S. (2014) Long-Term Outcomes of Proximal Gastrectomy versus Total Gastrectomy for Upper-Third Gastric Cancer. Journal of Gastric Cancer, 14, 246-251. https://doi.org/10.5230/jgc.2014.14.4.246
Cananzi, F.C.M., Ruspi, L., Samà, L., Renne, S.L., Sicoli, F. and Quagliuolo, V. (2022) The Gist of Surgical Margins in GIST: A Narrative Review. Laparoscopic Surgery, 6, Article No. 4. https://doi.org/10.21037/ls-20-139
Gong, N., Wong, C.S. and Chu, Y.C. (2011) Is Lymph Node Metastasis a Common Feature of Gastrointestinal Stromal Tumor? PET/CT Correlation. Clinical Nuclear Medicine, 36, 678-682. https://doi.org/10.1097/RLU.0b013e318219ad31
Madhavan, A., Phillips, A.W., Donohoe, C.L., Willows, R.J., Immanuel, A., Verril, M. and Griffin, S.M. (2018) Surgical Management of Gastric Gastrointestinal Stromal Tumours: Comparison of Outcomes for Local and Radical Resection. Gastroenterology Research and Practice, 2018, Article ID: 2140253. https://doi.org/10.1155/2018/2140253
Zhang, H., Liu, X., Zheng, Z., Yin, J. and Zhang, J. (2022) Safety, Efficacy and Selection Strategy of Laparoscopic Local Gastrectomy for Gastrointestinal Stromal Tumors in the Esophagogastric Junction. Frontiers in Surgery, 9, Article 1015126. https://doi.org/10.3389/fsurg.2022.1015126
Piessen, G., Lefèvre, J.H., Cabau, M., Duhamel, A., Behal, H., Perniceni, T., Mabrut, J.Y., Regimbeau, J.M., Bonvalot, S., Tiberio, G.A., Mathonnet, M., Regenet, N., Guillaud, A., Glehen, O., Mariani, P., Denost, Q., Maggiori, L., Benhaim, L., Manceau, G., Mutter, D., et al. and the FREGAT Working Group (2015) Laparoscopic Versus Open Surgery for Gastric Gastrointestinal Stromal Tumors: What Is the Impact on Postoperative Outcome and Oncologic Results? Annals of Surgery, 262, 831-840. https://doi.org/10.1097/SLA.0000000000001488
Ma, F., Guo, D., Zhang, B., Zhang, Y., Peng, L., Ma, Q., Ji, S., Chai, J., Hua, Y., Chen, X., Wang, H., Xu, S. and Luo, S. (2020) Short and Long-Term Outcomes after Proximal Gastrectomy with Double Tract Reconstruction for Siewert Type III Adenocarcinoma of the Esophagogastric Junction: A Propensity Score Matching Study from a 10-Year Experience in a High-Volume Hospital. Journal of Gastrointestinal Oncology, 11, 1261-1273. https://doi.org/10.21037/jgo-20-475
Hinoshita, E., Takahashi, I., Onohara, T., Nishizaki, T., Matsusaka, T., Wakasugi, K., Ishikawa, T., Kume, K., Maehara, Y. and Sugimachi, K. (2001) The Nutritional Advantages of Proximal Gastrectomy for Early Gastric Cancer. Hepato-Gastroen-terology, 48, 1513-1516.
Shaibu, Z., Chen, Z., Mzee, S.A.S., Theophilus, A. and Danbala, I.A. (2020) Effects of Reconstruction Techniques after Proximal Gastrectomy: A Systematic Review and Meta-Analysis. World Journal of Surgical Oncology, 18, Article No. 171. https://doi.org/10.1186/s12957-020-01936-2
Kwag, S., Jung, S., Lee, Y., Jung, C., Park, S., Choi, S., Hong, S., Jung, E., Joo, Y. and Ha, W. (2010) The Risk Factors of Reflux Complication after Gastrectomy for Proximal Gastric Cancer. Journal of the Korean Surgical Society, 79, 246-252. https://doi.org/10.4174/jkss.2010.79.4.246
Zhao, L., Ling, R., Chen, J., Shi, A., Chai, C., Ma, F., Zhao, D. and Chen, Y. (2021) Clinical Outcomes of Proximal Gastrectomy versus Total Gastrectomy for Proximal Gastric Cancer: A Systematic Review and Meta-Analysis. Digestive Surgery, 38, 1-13. https://doi.org/10.1159/000506104
Shoji, Y., Nunobe, S., Ida, S., Kumagai, K., Ohashi, M., Sano, T. and Hiki, N. (2019) Surgical Outcomes and Risk Assessment for Anastomotic Complications after Laparoscopic Proximal Gastrectomy with Double-Flap Technique for Upper-Third Gastric Cancer. Gastric Cancer, 22, 1036-1043. https://doi.org/10.1007/s10120-019-00940-0
Ueda, Y., Kawasaki, T., Tanabe, S., et al. (2022) Safety and Feasibility of Novel Reconstruction Method Using Long and Narrow Cobra-Head-Shaped Gastric Tube in Laparoscopic Proximal Gastrectomy for Cancer. (Preprint) https://doi.org/10.21203/rs.3.rs-1003160/v2