Application of tension gastrophasty approach technique in McKeown procedure in esophageal cancers

doi:10.3877/cma.j.issn.1674-6899.2026.01.005

Abstract

Abstract:

Objective

To evaluate the impact of tension gastrophasty approach (TGA) technique on postoperative complications and functional recovery in patients undergoing McKeown esophagectomy for esophageal cancer.

Methods

Clinical data from 75 patients treated in 2024 (personalized group) were compared with 126 historical controls (conventional group) from 2022 to 2023. The primary endpoint was anastomotic leakage rate, with secondary endpoints including reflux symptoms and nutritional status.

Results

The personalized group demonstrated significantly lower rates of anastomotic leakage (5.3% vs. 15.9%, P=0.026) and moderate-to-severe reflux (21.3% vs. 35.7%, P=0.032). At 6 months postoperatively, this group also showed superior weight recovery (-5.8%±2.9% vs. -13.1%±6.2%, P<0.001) compared to the conventional group.

Conclusions

The personalized gastric conduit technique is safe and feasible for McKeown esophagectomy, reducing anastomotic leakage and reflux while improving postoperative nutritional recovery. These findings support its clinical adoption.

Key words: Esophageal surgery, Gastric conduit, Anastomotic leak

Huan Zhang, Jicheng Xiong, Simiao Lu, Wenwu He, Guangyuan Liu, Kangning Wang, Qiang Fang, Yongtao Han, Xuefeng Leng. Application of tension gastrophasty approach technique in McKeown procedure in esophageal cancers[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2026, 19(01): 25-29.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2026.01.005

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2026/V19/I01/25

Figures/Tables 5

References 19

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	张力性组(n＝75)	传统组(n＝126)	统计值	P值
年龄(岁)	65.2±8.7	63.1±9.4	t＝1.762	0.080
性别[例(%)]			χ²＝0.745	0.388
男	62(82.7)	98(77.8)
女	13(17.3)	28(22.2)
高血压[例(%)]	27(36.0)	53(42.1)	χ²＝0.721	0.396
糖尿病[例(%)]	21(28.0)	41(32.5)	χ²＝0.454	0.500
新辅助治疗[例(%)]	62(82.7)	101(80.2)	χ²＝0.193	0.661
肿瘤分期[例(%)]			χ²＝1.894	0.169
Ⅰ＋Ⅱ期	35(46.7)	50(39.7)
Ⅲ期	40(53.3)	76(60.3)
肿瘤位置[例(%)]			χ²＝0.157	0.924
胸上段	14(18.7)	20(18.8)
胸中段	41(54.7)	71(56.3)
胸下段	20(26.7)	35(27.8)

	张力性组(n＝75)	传统组(n＝126)	统计值	P值
年龄(岁)	65.2±8.7	63.1±9.4	t＝1.762	0.080
性别[例(%)]			χ²＝0.745	0.388
男	62(82.7)	98(77.8)
女	13(17.3)	28(22.2)
高血压[例(%)]	27(36.0)	53(42.1)	χ²＝0.721	0.396
糖尿病[例(%)]	21(28.0)	41(32.5)	χ²＝0.454	0.500
新辅助治疗[例(%)]	62(82.7)	101(80.2)	χ²＝0.193	0.661
肿瘤分期[例(%)]			χ²＝1.894	0.169
Ⅰ＋Ⅱ期	35(46.7)	50(39.7)
Ⅲ期	40(53.3)	76(60.3)
肿瘤位置[例(%)]			χ²＝0.157	0.924
胸上段	14(18.7)	20(18.8)
胸中段	41(54.7)	71(56.3)
胸下段	20(26.7)	35(27.8)

	张力性组(n＝75)	传统组(n＝126)	统计值	P值
手术时间(min)	315±43	302±39	t＝1.762	0.080
吻合口瘘[例(%)]	4(5.3)	20(15.9)	χ²＝4.967	0.026
吻合口狭窄[例(%)]	10(13.3)	21(16.7)	χ²＝0.401	0.527
需药物干预的反流[例(%)]	16(21.3)	45(35.7)	χ²＝ 4.60	0.032
术后6个月体重恢复率(±s)	－5.8±2.9	－13.1±6.2	t＝ 9.47	<0.001

	张力性组(n＝75)	传统组(n＝126)	统计值	P值
手术时间(min)	315±43	302±39	t＝1.762	0.080
吻合口瘘[例(%)]	4(5.3)	20(15.9)	χ²＝4.967	0.026
吻合口狭窄[例(%)]	10(13.3)	21(16.7)	χ²＝0.401	0.527
需药物干预的反流[例(%)]	16(21.3)	45(35.7)	χ²＝ 4.60	0.032
术后6个月体重恢复率(±s)	－5.8±2.9	－13.1±6.2	t＝ 9.47	<0.001

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