Effect of jejunal interposition in patients with early proximal gastric cancer

Abstract

Objective To compare the surgical safety, postoperative complications of patients with early proximal gastric cancer of different methods of reconstruction, and choose the best methods of digestive track reconstruction. Methods Clinical data of 92 patients with early proximal gastric cancer treated in our hospital from January, 2013 to June, 2016 was retrospectively analyzed. They were divided into 3 groups according to the different digestive tract reconstruction, 45 esophagogastrostomy(EG group), 20 Single-canal jejunum interposition(JI group) and 27 double tract reconstruction(DTR group). The data was analyzed using SPSS21.0 statistical software. Perioperative indicators were showed by (±s), and compared with t test, the measurement data was compared using single factor analysis of variance between the three groups; Postoperative complications were compared using the χ2 test. P<0.05 was statistically significant. Results Compared with JI group and DTR group, EG group had shorter operation time, but there was no significant difference in intraoperative blood loss, postoperative hospital stay, ventilation time in the three groups. The differences in total postoperative complications were statistically significant (P<0.05). Especially, the incidence of reflux esophagitis was significantly higher in the EG group than in the JI or DRT group (P<0.05). But no significant difference between JI group and the DTR group were found. Conclusion Patients underwent proximal gastrectomy followed with conventional EG has higher rate of reflux esophagitis. JI and DTR may be the reasonable choice of digestive tract reconstruction after radical resection of early proximal gastric cancer. Key words: Stomach Neoplasms; Gastrectomy; Jejunal interposition(JI and DTR)