ID | 66721 |
フルテキストURL | |
著者 |
Kuroda, Shinji
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
ORCID
Kaken ID
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Ishida, Michihiro
Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima
Choda, Yasuhiro
Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima
Muraoka, Atsushi
Department of Surgery, Kagawa Rosai Hospital
Hato, Shinji
Department of Surgery, Shikoku Cancer Center
Kagawa, Tetsuya
Department of Surgery, Shikoku Cancer Center
Tanaka, Norimitsu
Department of Surgery, Kagawa Prefectural Central Hospital
Mitsuhashi, Toshiharu
Center for Innovative Clinical Medicine, Okayama University Hospital
Kaken ID
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Kakiuchi, Yoshihiko
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kikuchi, Satoru
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kaken ID
Nishizaki, Masahiko
Department of Surgery, Tsuyama Chuo Hospital
Kagawa, Shunsuke
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
ORCID
Kaken ID
publons
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Fujiwara, Toshiyoshi
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
ORCID
Kaken ID
publons
researchmap
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抄録 | Background: Double-flap technique (DFT) is a reconstruction procedure after proximal gastrectomy (PG). We previously reported a multi-center, retrospective study in which the incidence of reflux esophagitis (RE) (Los Angeles Classification ≥Grade B [LA-B]) 1 year after surgery was 6.0%. There have been many reports, but all of them were retrospective. Thus, a multi-center, prospective study was conducted.
Methods: Laparoscopic PG + DFT was performed for cT1N0 upper gastric cancer patients. The primary endpoint was the incidence of RE (≥LA-B) 1 year after surgery. The planned sample size was 40, based on an estimated incidence of 6.0% and an upper threshold of 20%. Results: Forty patients were recruited, and 39, excluding one with conversion to total gastrectomy, received protocol treatment. Anastomotic leakage (Clavien–Dindo ≥Grade III) was observed in one patient (2.6%). In 38 patients, excluding one case of postoperative mortality, RE (≥LA-B) was observed in two patients (5.3%) 1 year after surgery, and the upper limit of the 95% confidence interval was 17.3%, lower than the 20% threshold. Anastomotic stricture requiring dilatation was observed in two patients (5.3%). One year after surgery, body weight change was 88.9 ± 7.0%, and PNI <40 and CONUT ≥5, indicating malnutrition, were observed in only one patient (2.6%) each. In the quality of life survey using the PGSAS-45 questionnaire, the esophageal reflux subscale score was 1.4 ± 0.6, significantly better than the public data (2.0 ± 1.0; p = 0.001). Conclusion: Laparoscopic DFT showed anti-reflux efficacy. Taken together with the acceptable incidence of anastomotic stricture, DFT can be an option for reconstruction procedure after PG. |
キーワード | anti-reflux surgery
double-flap technique
gastric cancer
Kamikawa procedure
proximal gastrectomy
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発行日 | 2024-02-22
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出版物タイトル |
Annals of Gastroenterological Surgery
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出版者 | Wiley
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ISSN | 2475-0328
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © 2024 The Authors.
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論文のバージョン | publisher
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DOI | |
Web of Science KeyUT | |
関連URL | isVersionOf https://doi.org/10.1002/ags3.12783
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ライセンス | https://creativecommons.org/licenses/by-nc-nd/4.0/
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Citation | Kuroda S, Ishida M, Choda Y, Muraoka A, Hato S, Kagawa T, et al. A multi-center, prospective, clinical study to evaluate the anti-reflux efficacy of laparoscopic double-flap technique (lD-FLAP Study). Ann Gastroenterol Surg. 2024; 00: 1–9. https://doi.org/10.1002/ags3.12783
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助成機関名 |
Okayama Medical Foundation
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