Comparison of proximal gastrectomy with tubular esophagogastric anastomosis and total gastrectomy with Roux-en-Y reconstruction in the treatment of adenocarcinoma of the esophagogastric junction of Siewert type II/III at stage II
Comparison of proximal gastrectomy with tubular esophagogastric anastomosis and total gastrectomy with Roux-en-Y reconstruction in the treatment of adenocarcinoma of the esophagogastric junction of Siewert type II/III at stage II
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Abstract Background Tubular anastomosis is commonly used in proximal gastrectomy; however, its use in stage II esophagogastric conjugate cancer is currently unclear.In this study, we investigated the short- and long-term clinical outcomes of Siewert II/III adenocarcinoma of the esophagogastric junction after modified proximal gastrectomy with tubular esophagogastric anastomosis compared with total gastrectomy with Roux-en-Y reconstruction.Methods We collected the clinical data of patients who underwent proximal gastrectomy tubular esophagogastric anastomosis (PG-TEA) and total gastrectomy Roux-en-Y reconstruction (TG-RY) from October 2015 to October 2018.The clinical characteristics, postoperative quality of life, nutritional status, and long-term survival outcomes of the two groups were compared.
Results There were 43 patients in the PG-TEA group and 80 patients in the TG-RY group, and there was no significant difference between the baseline data of the groups.The operation time of the PG-TEA group was shorter, there was less intraoperative bleeding, ngetikin.com and the feeding time was earlier, which was conducive to postoperative recovery.Reflux esophagitis was more evident in the PG-TEA group than in the TG-RY group, and there was no significant difference in the incidence of anastomotic hiboost 4k smart link ulcers or other complications.Three months after surgery, the nutritional status of the PG-TEA group was better than the TG-RY group.
By the 6th postoperative month, there was no significant difference between the two groups.Regarding quality of life, the PG-TEA group was superior to the TG-RY group in terms of diarrhea and dumping syndrome.In addition, the PG-TEA group had higher satisfaction with daily life and higher-quality meals.There was no significant difference in overall survival between the two groups.
Conclusions Proximal gastrectomy tubular gastroesophageal anastomosis is a surgical procedure for stage II Siewert type II and III AEG.It achieves similar clinical outcomes to those after total gastrectomy and can be further applied in the clinic.