Double-tract Reconstruction is Superior to Esophagogastrostomy in Controlling Reflux Esophagitis and Enhancing Quality of Life After Proximal Gastrectomy: Results from a Prospective Randomized Controlled Clinical Trial in China

Overview

Journal Chin J Cancer Res

Specialty Oncology

Date 2024 Jan 11

PMID 38204447

Authors

Yinan Zhang

Hongtao Zhang

Yan Yan

Ke Ji

Ziyu Jia

Heli Yang

Biao Fan

Anqiang Wang

Xiaojiang Wu

Ji Zhang

Jiafu Ji

Xin Ji

Zhaode Bu

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to prospectively compare double-tract reconstruction (DTR) and esophagogastrostomy (EG) after proximal gastrectomy (PG) regarding the incidence of reflux esophagitis, quality of life (QOL), nutritional status and surgical safety.

Methods: This study was a randomized controlled trial. Patients eligible for PG were enrolled and randomly assigned to the EG group and DTR group. The characteristics of patients, parameters for surgical safety, incidence of reflux esophagitis, nutrition status and QOL were collected and compared between the two groups. Univariate analysis and multivariate analysis were performed to determine the significant factors affecting the incidence of reflux esophagitis after PG.

Results: Thirty-seven patients of the EG group and 36 patients of the DTR group were enrolled. The incidence of reflux esophagitis was significantly lower in the DTR group than in the EG group (8.3% 32.4%, P=0.019). The DTR group demonstrated a more favorable QOL than the EG group after PG. The nutritional status was balanced within the EG group and the DTR group. The operation time was longer in the DTR group than in the EG group (191 min 221 min, P=0.001), while surgical safety was similar in the two groups.

Conclusions: Our research demonstrated that DTR is superior to EG after PG in terms of the incidence of reflux esophagitis and provides a more satisfactory QOL without increasing surgical complications or sacrificing nutritional status.

Citing Articles

Updated Review of Proximal Gastrectomy for Gastric Cancer or Cancer of the Gastroesophageal Junction.

Irino T, Ohashi M, Hayami M, Makuuchi R, Ri M, Sano T J Gastric Cancer. 2025; 25(1):228-246.

PMID: 39822177 PMC: 11739649. DOI: 10.5230/jgc.2025.25.e12.

Novel reconstruction method using long and narrow gastric tube in laparoscopic proximal gastrectomy for cancer: a retrospective case series study.

Ueda Y, Kawasaki T, Tanabe S, Suzuki K, Ninomiya S, Etoh T Front Surg. 2024; 11:1413939.

PMID: 39119245 PMC: 11306146. DOI: 10.3389/fsurg.2024.1413939.

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