Clinical Outcome of Modified Laparoscopy-Assisted Proximal Gastrectomy Compared to Conventional Proximal Gastrectomy or Total Gastrectomy for Upper-Third Early Gastric Cancer with Special References to Postoperative Reflux Esophagitis.
10.5230/jgc.2015.15.3.191
- Author:
Yeon Ju HUH
1
;
Hyuk Joon LEE
;
Seung Young OH
;
Kyung Goo LEE
;
Jun Young YANG
;
Hye Seong AHN
;
Yun Suhk SUH
;
Seong Ho KONG
;
Kuhn Uk LEE
;
Han Kwang YANG
Author Information
1. Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. appe98@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Stomach neoplasms;
Laparoscopy;
Gastrectomy
- MeSH:
Esophagitis, Peptic*;
Esophagus;
Gastrectomy*;
Humans;
Incidence;
Laparoscopy;
Medical Records;
Nutritional Status;
Postoperative Complications;
Prognosis;
Recurrence;
Stomach Neoplasms*;
Survival Rate
- From:Journal of Gastric Cancer
2015;15(3):191-200
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study evaluated the functional and oncological outcomes of proximal gastrectomy (PG) in comparison with total gastrectomy (TG) for upper-third early gastric cancer (EGC). MATERIALS AND METHODS: The medical records of upper-third EGC patients who had undergone PG (n=192) or TG (n=157) were reviewed. The PG group was further subdivided into patients who had undergone conventional open PG (cPG; n=157) or modified laparoscopy-assisted PG (mLAPG; n=35). Patients who had undergone mLAPG had a longer portion of their intra-abdominal esophagus preserved than patients who had undergone cPG. Surgical morbidity, recurrence, long-term nutritional status, and the incidence of reflux esophagitis were compared between the groups. RESULTS: The rate of postoperative complications was significantly lower for PG than TG (16.7% vs. 31.2%), but the five-year overall survival rate was comparable between the two groups (99.3% vs. 96.3%). Postoperative levels of hemoglobin and albumin were significantly higher for patients who had undergone PG. However, the incidence of reflux esophagitis was higher for PG than for TG (37.4% vs. 3.7%; P<0.001). mLAPG was related to a lower incidence of reflux esophagitis after PG (P<0.001). CONCLUSIONS: Compared to TG, PG showed an advantage in terms of postoperative morbidity and nutrition, and there was a comparable prognosis between the two procedures. Preserving the intra-abdominal esophagus may lower the incidence of reflux esophagitis associated with PG.
