Abstract:
Objective
To explore the clinical effect of laparoscopic proximal gastrectomy （LPG）combined with modified esophagogastrostomy to reconstruct His Angle on postoperative reflux esophagitis （RE）.
Methods
108 patients with LPG from January 2021 to September 2023 were prospectively selected as the study objects， and were divided into traditional group and improved group by envelope method， with 54 patients in each group.Both groups were treated with LPG.In the process of digestive tract reconstruction， traditional esophagogastric anastomosis was used in the traditional group， and modified esophagogastrostomy was used in the improved group to reconstruct His Angle.SPSS 25.0 was used for data analysis.Measurement data such as perioperative indicators and total score of RDQ were expressed with （x± s ）.Independent sample t test was used for comparison.The statistical data of complication rate， Visick score grade and RE severity grade were expressed by ［cases （%）］， and compared by χ2 test or Rank Sum test.P＜0.05 was considered to be statistically significant.
Results
There were no significant differences in operation time， digestive tract reconstruction time， number of lymph nodes dissection， intraoperative blood loss， intestinal function recovery time and postoperative hospitalization time between the improved group and the traditional group （P＞0.05）.The overall incidence of complications in the improved group was significantly lower than that in the traditional group （22.2%vs. 40.7%， P＜0.05）.The Visick score and the distribution of RE severity in the improved group were better than those in the traditional group， and the total score of RDQ was significantly lower than that in the traditional group， with statistical significance （P＜0.05）.
Conclusion
LPG combined with modified esophagogastrostomy to reconstruct His Angle is safe and feasible， does not increase perioperative related risks， and can effectively reduce the risk of postoperative complications， and has significant anti-reflux effect， so it is a relatively ideal operation.
Key words:
Stomach Neoplasms,
Laparoscopes,
Gastrectomy,
Reconstruct His Angle,
Esophagitis,Peptic
Fangpeng Chen, Dawei Yang, Congwen Jin. Effect of laparoscopic proximal gastrectomy combined with modified esophagogastrostomy to reconstruct His Angle in patients with postoperative reflux esophagitis[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 15-18.