World Journal of Surgery

, 35:2245

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

  • Omar Khan
  • Steven Goh
  • Ben Byrne
  • Shaw Somers
  • Stuart Mercer
  • Simon Toh
Article

DOI: 10.1007/s00268-011-1235-z

Cite this article as:
Khan, O., Goh, S., Byrne, B. et al. World J Surg (2011) 35: 2245. doi:10.1007/s00268-011-1235-z

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.

Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Omar Khan
    • 1
  • Steven Goh
    • 1
  • Ben Byrne
    • 1
  • Shaw Somers
    • 1
  • Stuart Mercer
    • 1
  • Simon Toh
    • 1
  1. 1.Department of Upper GI SurgeryQueen Alexandra HospitalPortsmouthUK