Abstract
BackgroundProximal gastrectomy with double-tract reconstruction (DTR) has been used for upper third gastric cancer as a function-preserving procedure. However, the safety and feasibility of laparoscopic proximal gastrectomy (LPG) with DTR remain uncertain. This study compared open proximal gastrectomy (OPG) with DTR and LPG with DTR for proximal gastric cancer.MethodsSixty-four patients who had undergone OPG with DTR and forty-six patients who had undergone LPG with DTR were enrolled in this case–control study. The clinical characteristics, surgical outcomes and postoperative nutrition index were analysed retrospectively.ResultsThe operation time was significantly longer in the LGP group than in the OPG group (258.3 min vs 205.8 min; p = 0.00). However, the time to first flatus and postoperative hospital stay were shorter in the LPG group [4.0 days vs 3.5 days (p = 0.00) and 10.6 days vs 9.2 days (p = 0.001), respectively]. No significant difference was found between the two groups in the number of retrieved lymph nodes, complications or reflux oesophagitis. The nutrition status was assessed using the haemoglobin, albumin, prealbumin and weight levels from pre-operation to six months after surgery. No significant difference was found between the groups.ConclusionLPG with DTR can be safely performed for proximal gastric cancer patients by experienced surgeons.
Highlights
The incidence of proximal gastric cancer is increasing [1, 2]
The body mass index (BMI) was higher in the open proximal gastrectomy (OPG) group than in the laparoscopic proximal gastrectomy (LPG) group (p = 0.01)
The operation time was significantly longer in the LPG group (258.3 min) than in the OPG group (205.8 min)
Summary
The incidence of proximal gastric cancer is increasing [1, 2]. The rate of oesophagogastric junctional adenocarcinoma has risen from 22.3% to 35.7% in the last twenty years [3]. For early-stage proximal gastric cancer, total gastrectomy and proximal gastrectomy are options. The benefits of total gastrectomy are lymph node dissection of the distal stomach and reduction of gastroesophageal reflux. Proximal gastrectomy with double-tract reconstruction (DTR) has been used for upper third gastric cancer as a function-preserving procedure. The safety and feasibility of laparoscopic proximal gastrectomy (LPG) with DTR remain uncertain. This study compared open proximal gastrectomy (OPG) with DTR and LPG with DTR for proximal gastric cancer
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