{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T21:19:28Z","timestamp":1778793568632,"version":"3.51.4"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gastrointestinal Oncology International Team Cooperation Project","award":["SZYJTD201804"],"award-info":[{"award-number":["SZYJTD201804"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1656058","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T06:29:04Z","timestamp":1763706544000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Vagus nerve preservation and double-flap technique in laparoscopic proximal 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