Functional outcomes of 100 patients with adenocarcinoma of the esophagogastric junction undergoing Cheng's GIRAFFE(®) reconstruction after proximal gastrectomy.
10.3760/cma.j.cn441530-20220414-00146
- Author:
Yan Qiang ZHANG
1
;
Zhi Yuan XU
1
;
Yi An DU
1
;
Li Tao YANG
1
;
Ling HUANG
1
;
Peng Fei YU
1
;
Can HU
1
;
Jian Fa YU
2
;
Hong Tao XU
3
;
Yun Hai WEI
4
;
Wei Ming YU
5
;
Xiang Dong CHENG
1
Author Information
1. Department of Gastric Surgery, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) , Hangzhou 310022, China.
2. Department of Gastrointestinal Surgery, Chinese Medicine Hospital of Zhejiang Province, Hangzhou 310006, China.
3. Department of Gastrointestinal Surgery, Zhejiang Lishui Central Hospital, Lishui 323000, China.
4. Department of Gastrointestinal Surgery, Zhejiang Huzhou Central Hospital, Huzhou 313000, China.
5. Department of Gastrointestinal Surgery, Zhejiang Ningbo Lihuili Hospital, Ningbo 315000, China.
- Publication Type:Journal Article
- Keywords:
Adenocarcinoma of the esophagogastric junction;
Cheng′s GIRAFFE(®) reconstruction;
Functional efficacy;
Proximal gastrectomy
- MeSH:
Adenocarcinoma/surgery*;
Aged;
Esophageal Neoplasms/surgery*;
Esophagitis, Peptic/etiology*;
Esophagogastric Junction/surgery*;
Female;
Gastrectomy/methods*;
Gastroesophageal Reflux/etiology*;
Humans;
Laparoscopy;
Male;
Middle Aged;
Reconstructive Surgical Procedures/methods*;
Recovery of Function;
Retrospective Studies;
Stomach Neoplasms/surgery*
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(5):447-453
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the functional outcomes and postoperative complications of Cheng's GIRAFFE reconstruction after proximal gastrectomy. Methods: A descriptive case series study was conducted. Clinical data of 100 patients with adenocarcinoma of the esophagogastric junction who underwent Cheng's GIRAFFE reconstruction after proximal gastrectomy in Cancer Hospital of University of Chinese Academy of Sciences (64 cases), Zhejiang Provincial Hospital of Chinese Medicine (24 cases), Lishui Central Hospital (10 cases), Huzhou Central Hospital (1 case) and Ningbo Lihuili Hospital (1 case) from September 2017 to June 2021 were retrospectively analyzed. Of 100 patients, 64 were males and 36 were females; the mean age was (61.3 ± 11.1) years and the BMI was (22.7±11.1) kg/m(2). For TNM stage, 68 patients were stage IA, 24 were stage IIA and 8 were stage IIB. Postoperative functional results and postoperative complications of radical gastrectomy with Giraffe reconstruction were analyzed and summarized. Gastroesophageal reflux disease questionnaire (RDQ) score and postoperative endoscopy were used to evaluate the occurrence of reflux esophagitis and its grade (grade N, grade A, grade B, grade C, and grade D from mild to severe reflux). The continuous data conforming to normal distribution were expressed as (mean ± standard deviation), and those with skewed distribution were presented as median (Q1, Q3). Results: All the 100 patients successfully completed R0 resection, including 77 patients undergoing laparoscopic surgery and 23 patients undergoing laparotomy. The Giraffe anastomosis time was (38.6±14.0) min; the blood loss was (73.0±18.4) ml; the postoperative hospital stay was 9.5 (8.2, 13.0) d; the hospitalization cost was (6.0±0.3) ten thousand yuan. Fourteen cases developed perioperative complications (14.0%), including 7 cases of pleural effusion or pneumonia, 3 cases of anastomotic leakage, 2 cases of gastric emptying disorder, 1 case of gastrointestinal hemorrhage and 1 case of anastomotic stenosis, who were all improved and discharged after symptomatic management. Patients were followed up for (33.3±1.6) months. Eight patients were found to have reflux symptoms by RDQ scale six months after surgery, and 11 patients (11/100,11.0%) were found to have reflux esophagitis by gastroscopy, including 6 in grade A, 3 in grade B, and 2 in grade C. All the patients could control their reflux symptoms with behavioral guidance or oral PPIs. Conclusion: Cheng's GIRAFFE reconstruction has good anti-reflux efficacy and gastric emptying function; it can be one of the choices of reconstruction methods after proximal gastrectomy.
