Surgical outcomes of laparoscopic proximal gastrectomy for upper-third gastric cancer: esophagogastrostomy, gastric tube reconstruction, and double-tract reconstruction
Abstract Background There is no consensus on the optimal reconstruction technique after proximal gastrectomy. The purpose of this study was to retrospectively compare the surgical outcomes among esophagogastrostomy (EG) anastomosis, gastric tube (GT) reconstruction and double-tract (DT) reconstructi...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-023-02219-9 |
| _version_ | 1827635776651788288 |
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| author | Jianhua Chen Fei Wang Shuyang Gao Yapeng Yang Ziming Zhao Jiahao Shi Liuhua Wang Jun Ren |
| author_facet | Jianhua Chen Fei Wang Shuyang Gao Yapeng Yang Ziming Zhao Jiahao Shi Liuhua Wang Jun Ren |
| author_sort | Jianhua Chen |
| collection | DOAJ |
| description | Abstract Background There is no consensus on the optimal reconstruction technique after proximal gastrectomy. The purpose of this study was to retrospectively compare the surgical outcomes among esophagogastrostomy (EG) anastomosis, gastric tube (GT) reconstruction and double-tract (DT) reconstruction in patients who underwent laparoscopic proximal gastrectomy (LPG) to clarify the superior reconstruction method. Methods This study enrolled 164 patients who underwent LPG at the Northern Jiangsu People's Hospital in Jiangsu between January 2017 to January 2022 (EG: 51 patients; GT: 77 patients; DT: 36 patients). We compared the clinical and pathological characteristics, surgical features, postoperative complications, nutritional status, and quality of life (QOL) among the above three groups. Results Mean operative time was longer with the DT group than the remaining two groups (p = 0.001). With regard to postoperative complications, considerable differences in the postoperative reflux symptoms (p = 0.042) and reflux esophagitis (p = 0.040) among the three groups were found. For the nutritional status, total protein, hemoglobin and albumin reduction rates in the GT group were significantly higher than the other two groups at 12 months postoperatively. In the PGSAS-45, three assessment items were better in the DT group significantly compared with the esophageal reflux subscale (p = 0.047, Cohen’s d = 0.44), dissatisfaction at the meal (p = 0.009, Cohen’s d = 0.58), and dissatisfaction for daily life subscale (p = 0.012, Cohen’s d = 0.56). Conclusions DT after LPG is a valuable reconstruction technique with satisfactory surgical outcomes, especially regarding reduced reflux symptoms, improving the postoperative nutritional status and QOL. |
| first_indexed | 2024-03-09T15:32:14Z |
| format | Article |
| id | doaj.art-7b8ed844ad5e4834866bec6313956293 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-09T15:32:14Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-7b8ed844ad5e4834866bec63139562932023-11-26T12:11:45ZengBMCBMC Surgery1471-24822023-10-0123111110.1186/s12893-023-02219-9Surgical outcomes of laparoscopic proximal gastrectomy for upper-third gastric cancer: esophagogastrostomy, gastric tube reconstruction, and double-tract reconstructionJianhua Chen0Fei Wang1Shuyang Gao2Yapeng Yang3Ziming Zhao4Jiahao Shi5Liuhua Wang6Jun Ren7Department of Clinical Medical College, The Yangzhou School of Clinical Medicine, Dalian Medical UniversityDepartment of Clinical Medical College, The Yangzhou School of Clinical Medicine, Dalian Medical UniversityDepartment of Clinical Medical College, The Yangzhou School of Clinical Medicine, Dalian Medical UniversityDepartment of General Surgery, Northern Jiangsu People’s Hospital, Clinical Medical School, Yangzhou UniversityDepartment of General Surgery, Northern Jiangsu People’s Hospital, Clinical Medical School, Yangzhou UniversityDepartment of General Surgery, Northern Jiangsu People’s Hospital, Clinical Medical School, Yangzhou UniversityDepartment of General Surgery, Northern Jiangsu People’s Hospital, Clinical Medical School, Yangzhou UniversityDepartment of General Surgery, Northern Jiangsu People’s Hospital, Clinical Medical School, Yangzhou UniversityAbstract Background There is no consensus on the optimal reconstruction technique after proximal gastrectomy. The purpose of this study was to retrospectively compare the surgical outcomes among esophagogastrostomy (EG) anastomosis, gastric tube (GT) reconstruction and double-tract (DT) reconstruction in patients who underwent laparoscopic proximal gastrectomy (LPG) to clarify the superior reconstruction method. Methods This study enrolled 164 patients who underwent LPG at the Northern Jiangsu People's Hospital in Jiangsu between January 2017 to January 2022 (EG: 51 patients; GT: 77 patients; DT: 36 patients). We compared the clinical and pathological characteristics, surgical features, postoperative complications, nutritional status, and quality of life (QOL) among the above three groups. Results Mean operative time was longer with the DT group than the remaining two groups (p = 0.001). With regard to postoperative complications, considerable differences in the postoperative reflux symptoms (p = 0.042) and reflux esophagitis (p = 0.040) among the three groups were found. For the nutritional status, total protein, hemoglobin and albumin reduction rates in the GT group were significantly higher than the other two groups at 12 months postoperatively. In the PGSAS-45, three assessment items were better in the DT group significantly compared with the esophageal reflux subscale (p = 0.047, Cohen’s d = 0.44), dissatisfaction at the meal (p = 0.009, Cohen’s d = 0.58), and dissatisfaction for daily life subscale (p = 0.012, Cohen’s d = 0.56). Conclusions DT after LPG is a valuable reconstruction technique with satisfactory surgical outcomes, especially regarding reduced reflux symptoms, improving the postoperative nutritional status and QOL.https://doi.org/10.1186/s12893-023-02219-9Gastric cancerLaparoscopic proximal gastrectomyEsophagogastrostomyDouble-tract reconstructionGastric tube reconstruction |
| spellingShingle | Jianhua Chen Fei Wang Shuyang Gao Yapeng Yang Ziming Zhao Jiahao Shi Liuhua Wang Jun Ren Surgical outcomes of laparoscopic proximal gastrectomy for upper-third gastric cancer: esophagogastrostomy, gastric tube reconstruction, and double-tract reconstruction BMC Surgery Gastric cancer Laparoscopic proximal gastrectomy Esophagogastrostomy Double-tract reconstruction Gastric tube reconstruction |
| title | Surgical outcomes of laparoscopic proximal gastrectomy for upper-third gastric cancer: esophagogastrostomy, gastric tube reconstruction, and double-tract reconstruction |
| title_full | Surgical outcomes of laparoscopic proximal gastrectomy for upper-third gastric cancer: esophagogastrostomy, gastric tube reconstruction, and double-tract reconstruction |
| title_fullStr | Surgical outcomes of laparoscopic proximal gastrectomy for upper-third gastric cancer: esophagogastrostomy, gastric tube reconstruction, and double-tract reconstruction |
| title_full_unstemmed | Surgical outcomes of laparoscopic proximal gastrectomy for upper-third gastric cancer: esophagogastrostomy, gastric tube reconstruction, and double-tract reconstruction |
| title_short | Surgical outcomes of laparoscopic proximal gastrectomy for upper-third gastric cancer: esophagogastrostomy, gastric tube reconstruction, and double-tract reconstruction |
| title_sort | surgical outcomes of laparoscopic proximal gastrectomy for upper third gastric cancer esophagogastrostomy gastric tube reconstruction and double tract reconstruction |
| topic | Gastric cancer Laparoscopic proximal gastrectomy Esophagogastrostomy Double-tract reconstruction Gastric tube reconstruction |
| url | https://doi.org/10.1186/s12893-023-02219-9 |
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