ID | 57709 |
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Author |
Kuroda, Shinji
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Choda, Yasuhiro
Department of Surgery, Hiroshima City Hiroshima Citizens Hospital
Otsuka, Shinya
Department of Surgery, Fukuyama Medical Center
Ueyama, Satoshi
Department of Surgery, Mihara Red Cross Hospital
Tanaka, Norimitsu
Department of Surgery, Kagawa Prefectural Center Hospital
Muraoka, Atsushi
Department of Surgery, Kagawa Rosai Hospital
Hato, Shinji
Department of Surgery, Shikoku Cancer Center
Kimura, Toshikazu
Department of Surgery, Okayama Saiseikai General Hospital,
Tanakaya, Kohji
Department of Surgery, Iwakuni Clinical Center
Kikuchi, Satoru
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Tanabe, Shunsuke
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Noma, Kazuhiro
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Nishizaki, Masahiko
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kagawa, Shunsuke
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Shirakawa, Yasuhiro
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kamikawa, Yasuaki
Department of Surgery, Matsuda Hospital
Fujiwara, Toshiyoshi
Department of Gastroenterological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Abstract | AIM:
As a result of the difficulty in effective prevention of gastroesophageal reflux, no standard reconstruction procedure after proximal gastrectomy (PG) has yet been established. The double-flap technique (DFT), or Kamikawa procedure, is an antireflux reconstruction procedure in esophagogastrostomy. The efficacy of DFT has recently been reported in several studies. However, these were all single-center studies with a limited number of cases.
METHODS: We conducted a multicenter retrospective study in which patients who underwent DFT, irrespective of disease type and reconstruction approach, at each participating institution between 1996 and 2015 were registered. Primary endpoint was incidence of reflux esophagitis at 1-year after surgery, and secondary endpoint was incidence of anastomosis-related complications. RESULTS: Of 546 patients who were eligible for this study, 464 patients who had endoscopic examination at 1-year follow up were evaluated for reflux esophagitis. Incidence of reflux esophagitis of all grades was 10.6% and that of grade B or higher was 6.0%. Male gender and anastomosis located in the mediastinum/intra-thorax were independent risk factors for grade B or higher reflux esophagitis (odds ratio [OR]: 4.21, 95% confidence interval [CI]: 1.44-10.9, P = 0.0109). Total incidence of anastomosis-related complications was 7.2%, including leakage in 1.5%, strictures in 5.5% and bleeding in 0.6% of cases. Laparoscopic reconstruction was the only independent risk factor for anastomosis-related complications (OR: 3.93, 95% CI: 1.93-7.80, P = 0.0003). CONCLUSION: Double-flap technique might be a feasible option after PG for effective prevention of reflux, although anastomotic stricture is a complication that must be well-prepared for. |
Keywords | Kamikawa procedure
antireflux surgery
double‐flap technique
esophagogastrostomy
proximal gastrectomy
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Published Date | 2018-10-11
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Publication Title |
Annals of Gastroenterological Surgery
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Volume | volume3
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Issue | issue1
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Publisher | Woley
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Start Page | 96
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End Page | 103
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ISSN | 2475-0328
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © 2018 The Authors
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File Version | publisher
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PubMed ID | |
DOI | |
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Related Url | isVersionOf https://doi.org/10.1002/ags3.12216
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License | http://creativecommons.org/licenses/by/4.0/
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