Comparison of the effect of different surgical treatment for proximal gastric cancer

Abstract

Objective To compare the clinical effect of proximal gastric malignant tumor treated by the total gastrectomy and the proximal gastrectomy.Methods 278 patients with gastric cancer were randomly divided into two groups by double blind method(1 ∶ 1).Patients in the two groups received total gastrectomy (TG)and proximal gastrectomy(PG) treatment,respectively.The surgery effect,postoperative complications,survival rate and tumor recurrence rate were compared between the two groups.Results In PG group,the average blood loss was (151.6 ± 26.4)mL,operation time was (124.5 ±36.2) min,hospital stay was(8.9 ± 3.1) days,which were significantly lower than those in TG group (231.5 ± 15.3) mL,(162.4 ± 24.8) min and (12.6 ± 6.2) days (t =45.352,36.521,11.243,all P ＜0.05).The lymph node excision rate of PG group was (13.2 ± 3.1)％,which was significantly lower than (16.4 ±4.6) ％ in TG group(t =9.654,P ＜ 0.05).The incidence rate of postoperative complications between the two groups had statistically significant difference(x2 =25.321,20.254,all P ＜ 0.05).The survival rates of 3 years,5 years in TG group were 62.16％,42.32％,those in PG group were 60.39％,34.23％.The 3 years survival rate had no significant difference between the two groups (x2 =6.321,P =0.079),5 years survival rate had statistically significant difference between the two groups (x2 =31.265,P =0.000).The recurrence rate in group TG was 22.30％,which was significantly lower than 34.53 ％ in PG group (x2 =29.365,P =0.000).Conclusion Average blood loss,operation time,hospitalization time and postoperative complications of PG group are less,,but the lymph node resection rate is low,tumor recurrence rate is high,the 5-year survival rate is lower than the TG after surgery.TG can be recommended for the proximal gastric malignancy. Key words: Gastrectomy; Stomach neoplasms