Double H-flap Technique, an Anti-reflux Adjunct to Esophagogastrostomy After Proximal Gastrectomy for Gastric Leiomyoma: A Case Report
Author(s): Carlos Miguel P. Perez, MD, Efren Gerald S. Soliman, MD, FPCS, Rodney B. Dofitas, MD, FPCS and Jeannette Marie S. Matsuo, MD, FPCS
A significant challenge after performing resection of the esophagogastric region, is the reconstruction that follows. Esophagogastrostomy is a simple and direct method to restore gastrointestinal continuity using a single anastomosis but is associated with reflux esophagitis and anastomotic stenosis. This case report presents a 29-year-old man with a bleeding gastroesophageal junction leiomyoma who underwent a proximal gastrectomy and an esophagogastrostomy reconstruction with a double H-flap technique to reduce the incidence of gastric reflux. This illustrative description of the double H-flap technique created a valve mechanism that mimicked the function of the resected sphincter and cardia. This anti-reflux adjunct technique is reproducible and effective in preventing gastroesophageal reflux symptoms after an esophagogastrostomy.
Key words: proximal gastrectomy, esophagogastrostomy, double flap technique, reflux esophagitis