Proximal Gastrectomy With Double-Tract Reconstruction for Gastroesophageal Junction Injury

The patient was a transient responder with recurrent hypotension requiring zone 1 partial aortic occlusion which was achieved with the pREBOA-PRO catheter (Prytime Medical, Boerne, TX) titrating to above-balloon systolic blood pressure of 90. The history of this technique arises from the oncology literature, with the primary benefits reported as less esophagitis and reflux, less protein-calorie malnutrition and weight loss, and less long-term vitamin deficiencies such as B12.1-4 Given the age of this patient, we felt that total gastrectomy would be significantly morbid, and anatomically he did not have enough remaining viable stomach to perform an esophagogastrostomy with fundoplication and thus would have been at risk of chronic esophagitis and reflux. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.