» Articles » PMID: 26468417

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

Overview
Date 2015 Oct 16
PMID 26468417
Citations 22
Authors
Affiliations
Soon will be listed here.
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.

Citing Articles

Carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapy.

Chen Y, Liu D, Wei K, Lin Y, Wang Z, Sun Q Front Oncol. 2025; 15:1525324.

PMID: 39995833 PMC: 11847669. DOI: 10.3389/fonc.2025.1525324.


Comparison of surgical outcomes and postoperative nutritional parameters between subtotal and proximal gastrectomy in patients with proximal early gastric cancer.

Soneda W, Terashima M, Koseki Y, Furukawa K, Fujiya K, Tanizawa Y Ann Gastroenterol Surg. 2025; 9(1):89-97.

PMID: 39759986 PMC: 11693550. DOI: 10.1002/ags3.12856.


Gastric cancer surgery in South Korea: Past, present, and future.

Kim S, Lee S, Eom B, Yoon H, Kim Y, Ryu K Chin J Cancer Res. 2024; 35(6):627-635.

PMID: 38204450 PMC: 10774143. DOI: 10.21147/j.issn.1000-9604.2023.06.07.


Effect of Vitamin B12 Replacement Intervals on Clinical Symptoms and Laboratory Findings in Gastric Cancer Patients after Total Gastrectomy.

Park S, Eom S, Lee H, Eom B, Yoon H, Kim Y Cancers (Basel). 2023; 15(20).

PMID: 37894305 PMC: 10605534. DOI: 10.3390/cancers15204938.


Outcomes of Proximal Versus Total Gastrectomy for Proximal Gastric Cancer: A Propensity Score-Matched Analysis of a Western Center Experience.

Uprak T, Ergenc M, Akmercan A, Yegen C J Gastrointest Surg. 2023; 27(8):1560-1567.

PMID: 37130980 DOI: 10.1007/s11605-023-05686-w.


References
1.
Imada T, Rino Y, Takahashi M, Suzuki M, Tanaka J, Shiozawa M . Postoperative functional evaluation of pylorus-preserving gastrectomy for early gastric cancer compared with conventional distal gastrectomy. Surgery. 1998; 123(2):165-70. View

2.
Kim D, Lee J, Kim W . Lower esophageal sphincter-preserving laparoscopy-assisted proximal gastrectomy in patients with early gastric cancer: a method for the prevention of reflux esophagitis. Gastric Cancer. 2012; 16(3):440-4. DOI: 10.1007/s10120-012-0202-1. View

3.
Shiraishi N, Adachi Y, Kitano S, Kakisako K, Inomata M, Yasuda K . Clinical outcome of proximal versus total gastrectomy for proximal gastric cancer. World J Surg. 2002; 26(9):1150-4. DOI: 10.1007/s00268-002-6369-6. View

4.
Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A . Completely laparoscopic proximal gastrectomy with jejunal interposition and lymphadenectomy. J Am Coll Surg. 2000; 191(1):114-9. DOI: 10.1016/s1072-7515(00)00283-0. View

5.
. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011; 14(2):113-23. DOI: 10.1007/s10120-011-0042-4. View