Surgical outcomes of laparoscopic proximal gastrectomy for upper-third gastric cancer: esophagogastrostomy, gastric tube reconstruction, and double-tract reconstruction

BMC Surgery

Research

Shuyang Gao¹  Jianhua Chen¹  Fei Wang¹  Yapeng Yang²  Ziming Zhao²  Jiahao Shi²  Liuhua Wang³  Jun Ren³ 

[1] Department of Clinical Medical College, The Yangzhou School of Clinical Medicine, Dalian Medical University, Yangzhou, People’s Republic of China;Department of General Surgery, Northern Jiangsu People’s Hospital, Clinical Medical School, Yangzhou University, 98 Nantong West Road, 225001, Yangzhou, People’s Republic of China;Department of General Surgery, Northern Jiangsu People’s Hospital, Clinical Medical School, Yangzhou University, 98 Nantong West Road, 225001, Yangzhou, People’s Republic of China;Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, People’s Republic of China;Department of General Surgery, General Surgery Institute of Yangzhou, Northern Jiangsu People’s Hospital, Yangzhou, People’s Republic of China;

关键词: Gastric cancer;    Laparoscopic proximal gastrectomy;    Esophagogastrostomy;    Double-tract reconstruction;    Gastric tube reconstruction;   

DOI  :  10.1186/s12893-023-02219-9

 received in 2023-08-01, accepted in 2023-10-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThere is no consensus on the optimal reconstruction technique after proximal gastrectomy. The purpose of this study was to retrospectively compare the surgical outcomes among esophagogastrostomy (EG) anastomosis, gastric tube (GT) reconstruction and double-tract (DT) reconstruction in patients who underwent laparoscopic proximal gastrectomy (LPG) to clarify the superior reconstruction method.MethodsThis study enrolled 164 patients who underwent LPG at the Northern Jiangsu People's Hospital in Jiangsu between January 2017 to January 2022 (EG: 51 patients; GT: 77 patients; DT: 36 patients). We compared the clinical and pathological characteristics, surgical features, postoperative complications, nutritional status, and quality of life (QOL) among the above three groups.ResultsMean operative time was longer with the DT group than the remaining two groups (p = 0.001). With regard to postoperative complications, considerable differences in the postoperative reflux symptoms (p = 0.042) and reflux esophagitis (p = 0.040) among the three groups were found. For the nutritional status, total protein, hemoglobin and albumin reduction rates in the GT group were significantly higher than the other two groups at 12 months postoperatively. In the PGSAS-45, three assessment items were better in the DT group significantly compared with the esophageal reflux subscale (p = 0.047, Cohen’s d = 0.44), dissatisfaction at the meal (p = 0.009, Cohen’s d = 0.58), and dissatisfaction for daily life subscale (p = 0.012, Cohen’s d = 0.56).ConclusionsDT after LPG is a valuable reconstruction technique with satisfactory surgical outcomes, especially regarding reduced reflux symptoms, improving the postoperative nutritional status and QOL.

【 授权许可】

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© BioMed Central Ltd., part of Springer Nature 2023