Article

World Journal of Surgery

, Volume 35, Issue 10, pp 2245-2251

Long-term Outcomes of Extended Proximal Gastrectomy for Oesophagogastric Junctional Tumours

  • Omar KhanAffiliated withDepartment of Upper GI Surgery, Queen Alexandra Hospital Email author 
  • , Steven GohAffiliated withDepartment of Upper GI Surgery, Queen Alexandra Hospital
  • , Ben ByrneAffiliated withDepartment of Upper GI Surgery, Queen Alexandra Hospital
  • , Shaw SomersAffiliated withDepartment of Upper GI Surgery, Queen Alexandra Hospital
  • , Stuart MercerAffiliated withDepartment of Upper GI Surgery, Queen Alexandra Hospital
  • , Simon TohAffiliated withDepartment of Upper GI Surgery, Queen Alexandra Hospital

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Abstract

Background

There is no consensus on the optimum approach for resection of oesophagogastric junctional (OGJ) tumours. We prospectively evaluated the efficacy of transabdominal radical extended proximal gastrectomy with oesophagogastric anastomosis (EPGOG) for selected tumours of the OGJ.

Methods

Between 1998 and 2007, 66 selected consecutive patients with tumours of the OGJ underwent successful EPGOG. Selection was limited to tumours where the maximal proximal extent was 36 cm ab oral. Pre-, peri-, and postoperative outcomes together with long-term survival data for these patients were prospectively collected.

Results

Median theatre time was 242 min (range = 120–480), with a median blood loss of 300 ml (range = 50–1720). Eighty-nine percent of patients were extubated in theatre; major complications occurred in 9 (14%) patients, with an overall in-hospital mortality rate of 8%. Thirty-five (53%) patients had nodal disease and the median lymph node yield was 13 (range = 4–36), with an R0 resection rate of 80%. In terms of long-term outcomes, the 2- and 5-year actuarial survival rates were 54 ± 6% and 41 ± 6%.

Conclusion

Extended radical proximal gastrectomy with oesophagogastric anastomosis for selected junctional tumours is a feasible technique which does not compromise oncological principles as evidenced by an excellent long-term survival rate.