When doctors remove part of the stomach to treat cancer, they need to reconnect the remaining stomach to the intestines. This can sometimes cause painful heartburn and weight loss. Researchers tested a new way of connecting these organs called the NI method and compared it to the traditional approach. The study of 115 patients found that the new technique significantly reduced heartburn symptoms and helped patients maintain their weight better. This suggests the NI method could be a safer option for cancer patients needing this type of surgery.

The Quick Take

  • What they studied: Whether a new way of reconnecting the stomach and intestines after cancer surgery could reduce heartburn and help patients keep their weight
  • Who participated: 115 patients with upper stomach or esophageal cancer who had surgery to remove part of their stomach. About 35 received the new NI method, and 80 received the traditional method
  • Key finding: Patients using the new NI method had zero cases of reflux esophagitis (painful heartburn), compared to 14.3% of patients using the traditional method. The NI group also lost about 2% less body weight at 6 and 12 months after surgery
  • What it means for you: If you or a loved one needs surgery to remove part of the stomach for cancer, asking your surgeon about the NI method may help prevent painful heartburn and help maintain healthy weight after surgery. However, this is still a newer technique, so discuss all options with your medical team

The Research Details

This was a retrospective study, meaning researchers looked back at medical records of patients who had already received surgery. They compared two groups: 35 patients who received the new NI-modified double-tract reconstruction and 80 patients who received the conventional method. Both groups had surgery at one of two hospitals for upper stomach or esophageal cancer.

The NI method involves a special way of connecting the remaining stomach to the small intestine (jejunum) that’s designed to help food move more naturally and prevent stomach acid from flowing backward into the esophagus. Researchers measured how much weight patients lost and how many developed reflux esophagitis (inflammation from acid reflux) at 6 and 12 months after surgery.

The two groups were similar in age, gender, and other important health factors at the start, which helps make the comparison fair.

This research matters because stomach cancer surgery can have difficult side effects. When doctors remove part of the stomach, the way they reconnect it affects how well patients eat and whether they suffer from painful heartburn. Finding a surgical technique that reduces these problems could significantly improve quality of life for cancer survivors. The NI method’s design is based on how the stomach normally works, which is why it may be more effective than traditional methods.

This study has some strengths: it compared two similar groups of patients, measured important outcomes like weight loss and heartburn, and found clear differences between groups. However, it also has limitations: it’s a retrospective study (looking backward rather than planning the study in advance), the sample size is relatively small, and it was conducted at only two hospitals. The results are promising but would benefit from larger, more rigorous studies to confirm these findings.

What the Results Show

The most important finding was the dramatic difference in reflux esophagitis (painful heartburn from acid backup). None of the 35 patients in the NI group developed this condition, while 14.3% (about 11 out of 80) patients in the conventional group did. This difference was statistically significant, meaning it’s unlikely to have happened by chance.

Regarding weight loss, both groups lost weight after surgery, which is common. However, the NI group consistently lost about 2% less body weight at both the 6-month and 12-month checkpoints. While this difference wasn’t large enough to be statistically significant in this study, it suggests a trend toward better nutrition preservation with the NI method.

Both surgical approaches were safe, with no major complications reported in either group. This is important because it means the new NI method doesn’t appear to introduce new risks compared to the traditional method.

The study noted that the NI method’s unique way of connecting the stomach and intestine appears to create more natural food passage. This may explain why patients experienced less heartburn and maintained weight better. The researchers observed that the strategic positioning of the connection point helps suppress acid reflux while allowing adequate nutrition to be absorbed.

Double-tract reconstruction is already a well-established surgical technique used to prevent heartburn after stomach removal. This study builds on that foundation by introducing a modification (the NI method) that appears to improve upon the traditional approach. The significant reduction in reflux esophagitis (from 14.3% to 0%) is particularly noteworthy compared to what’s typically seen with conventional methods, suggesting this modification addresses a real problem in current surgical practice.

This study has several important limitations to consider. First, it’s a retrospective study, meaning researchers looked at past medical records rather than planning the study in advance and following patients forward. Second, the sample size is relatively small (115 patients total), which limits how much we can generalize the findings. Third, the study was conducted at only two hospitals, so results might differ in other settings. Fourth, the study doesn’t include long-term follow-up beyond 12 months. Finally, this is a newer technique, so there’s limited experience with it compared to the conventional method that’s been used for many years.

The Bottom Line

Based on this research, the NI-modified double-tract reconstruction appears to be a safe and effective option for patients undergoing proximal gastrectomy (removal of the upper part of the stomach) for cancer. The evidence suggests it significantly reduces the risk of painful heartburn and may help preserve body weight better than traditional methods. However, these findings are preliminary and based on a relatively small study. Patients should discuss this technique with their surgical team to determine if it’s appropriate for their specific situation. Confidence level: Moderate - the findings are promising but need confirmation with larger studies.

This research is most relevant to patients diagnosed with upper stomach cancer or esophageal cancer who need surgery to remove part of their stomach. It’s also important for surgeons who perform these procedures, as it offers a potentially better surgical option. Family members and caregivers of cancer patients should be aware of this technique as they help with treatment decisions. This research is less relevant to people without stomach or esophageal cancer, though it may eventually benefit other patients requiring similar surgery.

Based on the study, patients should expect to see benefits relatively quickly. The reduction in heartburn symptoms would likely be noticeable within the first few weeks after surgery as the surgical site heals. The weight stabilization benefits become clearer over the first 6-12 months as patients recover and resume normal eating patterns. Long-term benefits beyond 12 months are unknown and would require additional research.

Want to Apply This Research?

  • Track weekly weight measurements and daily heartburn symptoms (frequency and severity on a 0-10 scale) for the first 12 months after surgery. This allows patients to monitor their recovery and share objective data with their healthcare team.
  • Users who have undergone this surgery should log their meals and note any heartburn symptoms that follow. This helps identify trigger foods and patterns. The app can send gentle reminders to eat small, frequent meals and stay upright after eating, which helps prevent reflux regardless of surgical technique.
  • Create a long-term tracking dashboard showing weight trends, heartburn frequency, and nutritional intake over months and years. Set milestone goals (e.g., return to baseline weight by 12 months) and celebrate progress. Share monthly summaries with healthcare providers to ensure recovery is on track.

This research describes a surgical technique for treating stomach and esophageal cancer. It is not medical advice and should not replace consultation with your healthcare team. The NI method is a newer surgical approach, and while this study shows promising results, it requires discussion with your surgeon to determine if it’s appropriate for your specific situation. All surgery carries risks, and individual outcomes vary. Patients should discuss all available surgical options, their benefits, and potential complications with their medical team before making treatment decisions. This information is for educational purposes only.