Efficacy comparison of total gastrectomy and proximal subtotal gastrectomy in the treatment of gastric cardia adenocarcinoma

Abstract

Objective To compare the effects of total gastrectomy and proximal subtotal gastrectomy on gastric cardia adenocarcinoma.Methods From July 2011 to July 2013,the clinical data of 82 patients with gastric cardia adenocarcinoma in Xinyang central hospital were retrospectively analyzed.The 82 patients were divided into observation group and control group,the patients in observation group were given total gastrectomy,and the patients in control group were given proximal subtotal gastrectomy.The 1-year and 3-year survival rate and incidence of postoperative complications were compared between the two groups.Results Thirty-nine patients in the observation group reached stage Ⅰ,Ⅱ and Ⅲ,the effective rate was 92.9％ in the observation group,which was significantly higher than that in the control group(80.0％),there was significant difference(P ＜0.05).In observation group,1 patient died,and 4 patients died in the control group.In observation group,the 1-year and 3-year survival rate was 83.3 ％ and 40.5％,which was significantly higher than that in the control group(52.5％ and 27.5％),there were significant differences(P ＜ 0.05).Eleven patients(26.2％) had postoperative complications in the observation group,which was less than that in the control group [15 cases(37.5％)],there was significant difference(P ＜ 0.05).Conclusions In terms of surgical resection cardia adenocarcinoma,especially stage Ⅲ and Ⅳ tumors,patients with total gastrectomy have longer survival rate,fewer complications,and better overall effect.However,the clinical recommendations should be based on the patient' s disease stage,tumor size to choose total gastrectomy or proximal subtotal gastrectomy. Key words: Gastric cardia adenocarcinoma; Total gastrectomy; Proximal gastrectomy; Efficacy