OBJECTIVETo investigate the safety and efficacy of the transabdominal-hiatal approach of radical gastrectomy for the advanced proximal gastric cancer.

METHODSThe clinical data of 40 advanced proximal gastric cancer patients with involvement of distal esophagus admitted in Tongcheng People's Hospital from June 2003 to September 2006 were analyzed retrospectively. Patients included 27 men and 13 women with a mean age of 56.1 years (range: 37 to 76 years). The data were compared with those of 40 proximal gastric cancer patients undergoing standard thoracoabdominal approach (control group) during the same period.

RESULTSAs compared with the control group, the transabdominal-hiatal approach showed less blood loss [(181.3 ± 63.7) ml vs.(248.8 ± 79.7) ml], shorter operating time [(4.1 ± 0.6) h vs. (5.3 ± 0.7) h], shorter ICU stay [(6.5 ± 5.7) d vs. (19.4 ± 18.0) d] and shorter postoperative hospital stay [(14.0 ± 2.3) d vs.(18.7 ± 3.0) d] (all P<0.05). The complication rates of transabdominal-hiatal approach group and thoracoabdominal approach group were 7.5% (3/40) and 10.0% (4/40), and the 5-year survival rates were 51.3% and 60.0%, respectively (both P>0.05).

CONCLUSIONThe transabdominal-hiatal approach of radical gastrectomy for proximal gastric cancer is safe and effective, which may substitute the standard thoracoabdominal technique.