Two types of digestive tract reconstruction after proximal gastrectomy for early gastroesophageal junction adenocarcinoma：a randomized controlled study
10.3760/cma.j.issn.1671-0274.2014.09.007
- VernacularTitle:早期食管胃结合部腺癌切除术后3S空肠间置与食管胃吻合两种消化道重建方式的对比研究
- Author:
Gongping WANG
1
;
Yantong YANG
;
Bo ZHOU
;
Ye CHEN
;
Canhui JIN
;
Zengfang WANG
;
Wei ZHANG
;
Zhenzhen WANG
;
Xiaoshan FENG
Author Information
1. 河南科技大学第一附属医院胃肠肿瘤外科
- Keywords:
Esophagogastric junction adenocarcinoma;
Proximal gastrectomy;
Digestive tract reconstruction;
Jejunal interposision;
Quality of life
- From:
Chinese Journal of Gastrointestinal Surgery
2014;(9):872-876
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction adenocarcinoma. Methods A total of 153 cases of early gastroesophageal junction adenocarcinoma who were planned to receive radical proximal gastrectomy from January 2003 to December 2011 were prospectively enrolled and randomly divided into two groups by table of random number according to methods of digestive tract reconstruction , including 3S anastomosis group (80 cases, 3S jejunal interposition) and traditional anastomosis group (73 cases, esophageal remnant gastric posterior wall anastomosis). Postoperative complications, operative time, mortality, nutritional parameters and postoperative quality of life were compared between these two groups. Results There were no significant differences between two groups in postoperative complications, operative time and mortality (all P>0.05). 3S anastomosis group was better in nutritional parameters than traditional group six months after operation (P<0.05). As compared to traditional group, incidence of reflux esophagitis decreased [20.0%(16/80) vs. 46.6%(34/73), P<0.01] and gastric emptying time prolonged obviously [(160.8 ±8.1) min vs. (61.1 ±10.8) min, P<0.01] in 3S anastomosis group 18 months after operation. Postoperative QLQ-C30 rating scale revealed quality of life was significantly higher in 3S anastomosis group as compared to traditional group. Conclusion Jejunal interposition is a better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction carcinoma.
