PS01.158: WHAT IS THE IDEAL RECONSTRUCTIVE TECHNIQUE FOR TYPE 2 GEJ TUMOURS—ESOPHAGOGASTROSTOMY OR ESOPHAGOJEJUNOSTOMY

Abstract

Abstract Background In the management of OG junction tumors the border issue arises in type 2 cancers. It can be managed with various options like esophago gastrectomy (Ivor Lewis), transabdominal extended transhiatal gastrectomy or total esophago gastrectomy depends upon the extent strectomy of the tumor above and below. After resection the reconstruction can be either with stomach or jejunum or colon. However the functional result after either of these procedures varies. The aim of this study is to know the functional outcome of different reconstruction methods after esophagogastrectomy for locally advanced Type 2 OG junction tumours. Methods 148 consecutive patients who underwent surgery for OG junction tumors in the last 6 years were evaluated. Of them 62 locally advanced type2 OG junction tumors were included in our study. 26 underwent Ivor Levis procedure with gastric replacement. 36 underwent extended transhiatal gastrectomy with esophago jejunal anastamosis. Intra operative details like pyloroplasty, Operative time, blood loss, the distal margin, nodal clearance was noted. The functional outcome since immediate postoperative period to 1 year of follow up is reviewed retrospectively and prospectively in few cases. Results There is no significant difference in operating time, blood loss. Two patients with Partial gastrectomy had positive distal margin even though it is not statistically significant. The average number of nodes harvested is higher with total gastrectomy group with jejunal anastamosis and it is statistically significant between 2 groups (P < 0.05).The GERD is more with gastric conduit when compared to Jejunal reconstruction but the weight loss is more with jejunal reconstruction when compared with gastric reconstruction. Conclusion The functional outcome and oncological outcome are superior with jejunal reconstruction after total gastrectomy when compared with gastric reconstruction after Ivor Lewis procedure. Disclosure All authors have declared no conflicts of interest.