Transhiatal Tunnel Valvuloplasty for Reconstruction Following the Laparoscopic Proximal Gastrectomy

The incidence of postoperative reflux esophagitis

Patients who meet the inclusion criteria will undergo laparoscopic proximal gastric cancer
 radical surgery, and esophagogastric anastomosis will be performed using the ThTV method.
 
 Review the surgical video and record the time for making the extracorporeal muscle flap,
 tunnel passage time, and anastomosis time. The production time of the muscle flap is based on
 the electric knife incision of the muscle flap as the starting point, and successfully
 penetrating the muscle flap as the endpoint. The tunnel passes through time, pulling the
 residual end of the esophagus, and starting to pass through the gastric muscle flap tunnel as
 the time starting point. The complete placement of the gastric tube into the lower
 mediastinum is used as the time endpoint. The anastomosis time is calculated from the first
 needle of suturing the residual stomach and the posterior wall of the esophagus until the end
 of the plasma flap suturing. Record perioperative indicators such as surgical time, bleeding
 volume, and postoperative hospital stay. The definition of anastomotic stenosis is that in
 gastroscopy, those who cannot pass through the anastomotic site with ultra-fine endoscopy are
 judged as anastomotic stenosis.
 
 Postoperative pathology was performed using the 8th edition AJCC staging. Follow up every
 three months after surgery, including blood tests, liver and kidney function, and tumor
 markers. According to the situation, choose gastroscopy, upper gastrointestinal imaging, and
 chest abdominal pelvic enhanced CT. Evaluate postoperative reflux symptoms such as heartburn
 and sternal pain using the Visick grading system. Gastroscopy Los Angeles grading was used to
 evaluate postoperative reflux esophagitis.