Association Between Reconstruction Technique and Clinical Outcomes in Advanced Gastric Cancer Patients Undergoing Proximal Gastrectomy

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2025 Jan 8

PMID 39766179

Authors

Katarzyna Sedlak

Karol Rawicz-Pruszynski

Zuzanna Pelc

Radoslaw Mlak

Katarzyna Geca

Magdalena Skorzewska

Krzysztof Zinkiewicz

Katarzyna Chawrylak

Wojciech P Polkowski

Affiliations

Soon will be listed here.

Abstract

Background: There is an upward shift in the incidence and localization of gastric cancer (GC). Proximal gastrectomy (PG) has been advocated as an alternative operation for upper-third GC. An uneventful postoperative course is currently measured using a well-defined textbook outcome (TO), which represents a composite of surgical quality metrics. The aim of this study was to compare TO after two reconstruction methods following PG: double-tract reconstruction (DTR) and posterior esophagogastrostomy with partial neo-fundoplication (EGF).

Materials And Methods: Primary proximal gastric adenocarcinoma patients who had undergone PG with DTR or EGF were included in this study. In a prospectively collected database, DTR and EGF were identified in 30 and 30 patients, respectively.

Results: Patients with DTR had a 5.5-fold higher chance of achieving TO compared to those with EGF (OR = 5.67; = 0.0266). No statistically significant differences in overall survival were noted when both reconstruction methods were compared.

Conclusion: In patients with proximal GC undergoing PG, TO is more likely to be achieved using DTR compared to EGF, with similar overall survival. Randomized controlled trials are warranted to indicate the preferred reconstruction technique after PG.

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