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01-05-2014

Comparison of Perioperative and Long-term Outcomes of Total and Proximal Gastrectomy for Early Gastric Cancer: A Multi-institutional Retrospective Study

Authors: Toru Masuzawa, Shuji Takiguchi, Motohiro Hirao, Hiroshi Imamura, Yutaka Kimura, Junya Fujita, Isao Miyashiro, Shigeyuki Tamura, Masahiro Hiratsuka, Kenji Kobayashi, Yoshiyuki Fujiwara, Masaki Mori, Yuichiro Doki

Published in: World Journal of Surgery | Issue 5/2014

Abstract

Background

Various surgical procedures are used to treat early gastric cancers in the upper third of the stomach (U-EGCs). However, there is no general agreement regarding the optimal surgical procedure.

Methods

The medical records of 203 patients with U-EGC were collected from 13 institutions. Surgical procedures were classified as Roux-en-Y esophagojejunostomy after total gastrectomy (TG-RY), esophagogastrostomy after proximal gastrectomy (PG-EG), or jejunal interposition after PG (PG-JI). Patient clinical characteristics and perioperative and long-term outcomes were compared among these three groups.

Results

TG-RY, PG-EG, and PG-JI were performed in 122, 49, and 32 patients, respectively. Tumors were larger in TG-RY patients than in PG-EG and PG-JI patients, and undifferentiated-type gastric adenocarcinoma tended to be more frequent in TG-RY than in PG-EG. The operative time was shorter for PG-EG than for PG-JI and TG-RY. Hospital stay and early postoperative complications were not different for the three procedures. With respect to gastrectomy-associated symptoms, a “stuck feeling” and heartburn tended to be more frequent in PG-EG patients, while dumping syndrome and diarrhea were more frequent in TG-RY patients. Post-surgical weight loss was not different among the three groups, however, serum albumin and hemoglobin levels tended to be lower in TG-RY patients.

Conclusion

Three surgical procedures for U-EGC did not result in differences in weight loss, but PG-EG and PG-JI were better than TG-RY according to some nutritional markers. In U-EGC, where patients are expected to have long survival times, PG-EG and PG-JI should be used rather than TG-RY.

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Title: Comparison of Perioperative and Long-term Outcomes of Total and Proximal Gastrectomy for Early Gastric Cancer: A Multi-institutional Retrospective Study
Authors: Toru Masuzawa
Shuji Takiguchi
Motohiro Hirao
Hiroshi Imamura
Yutaka Kimura
Junya Fujita
Isao Miyashiro
Shigeyuki Tamura
Masahiro Hiratsuka
Kenji Kobayashi
Yoshiyuki Fujiwara
Masaki Mori
Yuichiro Doki
Publication date: 01-05-2014
Publisher: Springer US
Published in: World Journal of Surgery / Issue 5/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-013-2370-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of Perioperative and Long-term Outcomes of Total and Proximal Gastrectomy for Early Gastric Cancer: A Multi-institutional Retrospective Study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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