Short-Term Outcomes After the Introduction of Valvuloplastic Esophagogastrostomy via the Double-Flap Technique: Safe Robot-Assisted Implementation, Antireflux Efficacy, and Nutritional Impact

Introduction: Proximal gastrectomy (PG) has recently gained attention as a minimally invasive surgical option and a function-preserving surgery for early gastric cancer in the upper stomach. Among the various reconstruction methods following proximal gastrectomy, the double-flap technique (DFT) has been reported to provide effective anti-reflux function. In this study, we introduced the valvuloplastic esophagogastrostomy by double flap technique (VEG-DFT) and retrospectively compared its short-term outcomes with those of the conventional side-overlap (SO) method. Methods A total of 24 patients with cT1bN0M0 early gastric cancer located in the upper third of the stomach underwent VEG at our institution between January 2020 and July 2024. Of these, 14 underwent VEG-SO (SO group), and 10 underwent VEG-DFT (DFT group). Results Operative time, intraoperative blood loss, and the incidence of perioperative complications (Clavien–Dindo grade ≥ II) were comparable between the two groups. Postoperative upper gastrointestinal contrast studies and endoscopy revealed a significantly lower incidence of gastroesophageal reflux disease in the DFT group. No cases of anastomotic stenosis or leakage were observed in either group. Although serum nutritional indicators—including albumin and prealbumin—showed no significant differences between groups at six months postoperatively, body weight loss was significantly greater in the DFT group. Conclusion DFT may influence postoperative eating behavior, potentially due to increased passage resistance or early satiety. VEG-DFT was safely introduced and demonstrated favorable reflux control.