BRIEF RESEARCH REPORT article
Front. Surg.
Sec. Surgical Oncology
This article is part of the Research TopicSurgical Management and Outcomes for Gastric CancerView all 7 articles
Vagus nerve preservation and double-flap technique in laparoscopic proximal gastrectomy
Provisionally accepted
- 1First People's Hospital of Kunshan, Kunshan, China
- 2Second Affiliated Hospital of Soochow University, Suzhou, China
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Objectives: Laparoscopic proximal gastrectomy has been a common treatment strategy for proximal early gastric cancer. The conventional double-flap technique (DFT), also called Kamikawa method, does not require vagus nerve preservation, which is precisely crucial to maintain quality of life and prevent postoperative reflux esophagitis. Methods: A single-center retrospective analysis was conducted on 37 gastric cancer patients undergoing laparoscopic proximal gastrectomy with vagus nerve preservation and double-flap technique. The hepatic and celiac branches were both preserved. A seromuscular double-flap was created through the auxiliary incision, and the anastomosis between the oesophagus and the remnant stomach was performed under laparoscopy. Results: 2.7% of the patients suffered from slight anastomotic stricture but subsequently recovered after conservative treatment. No patients experienced anastomotic bleeding or leakage. No food residue and GERD (Los Angeles classification grade B or higher) were observed in any patients 6 months later. Ultrasonography showed that the gallbladder contractile function was normal in all patients. Conclusion: Although long-term follow-up and a larger number of patients are required to evaluate the functional outcomes, our technique provides a minimally invasive surgical option for proximal early gastric cancer, especially in the prevention of postoperative reflux esophagitis.
Keywords: Proximal gastrectomy, Laparoscopy, double-flap, Vagus Nerve, Gastroesophageal reflux disease
Received: 29 Jun 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 SUN, SHEN, HUA, ZHANG and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yong-you Wu, wuyongyou72@126.com
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