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Laparoscopic Proximal Gastrectomy with Jejunal Interposition for Early Proximal Gastric Cancer

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Abstract

Purpose

Proximal gastrectomy has been more advantageous than total gastrectomy in early cancer in the upper third of the stomach. Jejunal interposition is a novel reconstruction technique to prevent reflux esophagitis and anastomotic stricture in proximal gastrectomy. The combination of these two procedures via laparoscopic approach is not yet widespread. Therefore, this study is to evaluate the feasibility and safety of this surgery.

Methods

This is a retrospective study on eight patients with laparoscopic proximal gastrectomy and jejunal interposition for early proximal gastric cancer. Patients were followed up at 1, 3, and 6 months and then at 6-month intervals to investigate complications, recurrence, metastasis, and survival.

Results

All cases were adenocarcinoma in the early stage (cT1N0M0). The median (range) operating time and postoperative hospital stay were 145 min (120–210) and 7 days (6–9), respectively. No complication (including reflux esophagitis and anastomotic stricture) occurred. All patients were alive without any recurrence or metastasis during the median follow-up of 28 months (ranged 6–40 months).

Conclusion

Laparoscopic proximal gastrectomy with jejunal interposition for early gastric cancer is safe and feasible with good long-term outcomes. Further large studies are required to evaluate the safety and efficacy of this procedure.

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References

  1. Parkin DM. International variation. Oncogene. 2004;23(38):6329–40. https://doi.org/10.1038/sj.onc.1207726.

    Article  CAS  PubMed  Google Scholar 

  2. Ahn HS, Lee HJ, Yoo MW, Jeong SH, Park DJ, Kim HH, et al. Changes in clinicopathological features and survival after gastrectomy for gastric cancer over a 20-year period. Br J Surg. 2011;98(2):255–60. https://doi.org/10.1002/bjs.7310.

    Article  CAS  PubMed  Google Scholar 

  3. Sehdev A, Catenacci DV. Gastroesophageal cancer: focus on epidemiology, classification, and staging. Discov Med. 2013;16(87):103–11.

    PubMed  Google Scholar 

  4. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. 2017;20(1):1–19. https://doi.org/10.1007/s10120-016-0622-4.

    Article  Google Scholar 

  5. Kumagai K, Shimizu K, Yokoyama N, Aida S, Arima S, Aikou T. Questionnaire survey regarding the current status and controversial issues concerning reconstruction after gastrectomy in Japan. Surg Today. 2012;42(5):411–8. https://doi.org/10.1007/s00595-012-0159-z.

    Article  PubMed  Google Scholar 

  6. Karanicolas PJ, Graham D, Gonen M, Strong VE, Brennan MF, Coit DG. Quality of life after gastrectomy for adenocarcinoma: a prospective cohort study. Ann Surg. 2013;257(6):1039–46. https://doi.org/10.1097/SLA.0b013e31828c4a19.

    Article  PubMed  PubMed Central  Google Scholar 

  7. 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. https://doi.org/10.1016/s1072-7515(00)00283-0.

    Article  CAS  PubMed  Google Scholar 

  8. Katai H, Sano T, Fukagawa T, Shinohara H, Sasako M. Prospective study of proximal gastrectomy for early gastric cancer in the upper third of the stomach. Br J Surg. 2003;90(7):850–3. https://doi.org/10.1002/bjs.4106.

    Article  CAS  PubMed  Google Scholar 

  9. Thomas GI, Merendino KA. Jejunal interposition operation; analysis of thirty-three clinical cases. J Am Med Assoc. 1958;168(13):1759–66. https://doi.org/10.1001/jama.1958.03000130025007.

    Article  CAS  PubMed  Google Scholar 

  10. An JY, Youn HG, Choi MG, Noh JH, Sohn TS, Kim S. The difficult choice between total and proximal gastrectomy in proximal early gastric cancer. Am J Surg. 2008;196(4):587–91. https://doi.org/10.1016/j.amjsurg.2007.09.040.

    Article  PubMed  Google Scholar 

  11. Wen L, Chen XZ, Wu B, Chen XL, Wang L, Yang K, et al. Total vs. proximal gastrectomy for proximal gastric cancer: a systematic review and meta-analysis. Hepato-gastroenterology. 2012;59(114):633–40. https://doi.org/10.5754/hge11834.

    Article  PubMed  Google Scholar 

  12. Nozaki I, Hato S, Kobatake T, Ohta K, Kubo Y, Kurita A. Long-term outcome after proximal gastrectomy with jejunal interposition for gastric cancer compared with total gastrectomy. World J Surg. 2013;37(3):558–64. https://doi.org/10.1007/s00268-012-1894-4.

    Article  PubMed  Google Scholar 

  13. Ichikawa D, Komatsu S, Kubota T, Okamoto K, Shiozaki A, Fujiwara H, et al. Long-term outcomes of patients who underwent limited proximal gastrectomy. Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. 2014;17(1):141–5. https://doi.org/10.1007/s10120-013-0257-7.

    Article  Google Scholar 

  14. Nomura E, Lee SW, Kawai M, Yamazaki M, Nabeshima K, Nakamura K, et al. Functional outcomes by reconstruction technique following laparoscopic proximal gastrectomy for gastric cancer: double tract versus jejunal interposition. World journal of surgical oncology. 2014;12:20. https://doi.org/10.1186/1477-7819-12-20.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Takayama Y, Kaneoka Y, Maeda A, Fukami Y, Onoe S. Comparison of outcomes of laparoscopy-assisted and open proximal gastrectomy with jejunal interposition for early gastric cancer in the upper third of the stomach: a retrospective observational study. Asian journal of endoscopic surgery. 2018;11(4):329–36. https://doi.org/10.1111/ases.12469.

    Article  PubMed  Google Scholar 

  16. Nomura E, Kayano H, Lee SW, Kawai M, Machida T, Yamamoto S, et al. Functional evaluations comparing the double-tract method and the jejunal interposition method following laparoscopic proximal gastrectomy for gastric cancer: an investigation including laparoscopic total gastrectomy. Surg Today. 2019;49(1):38–48. https://doi.org/10.1007/s00595-018-1699-7.

    Article  CAS  PubMed  Google Scholar 

  17. Kinoshita T, Gotohda N, Kato Y, Takahashi S, Konishi M, Kinoshita T. Laparoscopic proximal gastrectomy with jejunal interposition for gastric cancer in the proximal third of the stomach: a retrospective comparison with open surgery. Surg Endosc. 2013;27(1):146–53. https://doi.org/10.1007/s00464-012-2401-6.

    Article  PubMed  Google Scholar 

  18. Katai H, Morita S, Saka M, Taniguchi H, Fukagawa T. Long-term outcome after proximal gastrectomy with jejunal interposition for suspected early cancer in the upper third of the stomach. Br J Surg. 2010;97(4):558–62. https://doi.org/10.1002/bjs.6944.

    Article  CAS  PubMed  Google Scholar 

  19. Nakamura M, Nakamori M, Ojima T, Katsuda M, Iida T, Hayata K, et al. Reconstruction after proximal gastrectomy for early gastric cancer in the upper third of the stomach: an analysis of our 13-year experience. Surgery. 2014;156(1):57–63. https://doi.org/10.1016/j.surg.2014.02.015.

    Article  PubMed  Google Scholar 

  20. Zhao P, Xiao SM, Tang LC, Ding Z, Zhou X, Chen XD. Proximal gastrectomy with jejunal interposition and TGRY anastomosis for proximal gastric cancer. World J Gastroenterol. 2014;20(25):8268–73. https://doi.org/10.3748/wjg.v20.i25.8268.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Tokunaga M, Ohyama S, Hiki N, Hoshino E, Nunobe S, Fukunaga T, et al. Endoscopic evaluation of reflux esophagitis after proximal gastrectomy: comparison between esophagogastric anastomosis and jejunal interposition. World J Surg. 2008;32(7):1473–7. https://doi.org/10.1007/s00268-007-9459-7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Digestive Surgery Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam

    Lam Viet Trung, Nguyen Vo Vinh Loc & Tran Phung Dung Tien

  2. Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam

    Lam Viet Trung, Nguyen Vo Vinh Loc, Tran Phung Dung Tien & Nguyen Lam Vuong

  3. Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam

    Nguyen Lam Vuong

Authors
  1. Lam Viet Trung
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  2. Nguyen Vo Vinh Loc
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  3. Tran Phung Dung Tien
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Correspondence to Nguyen Lam Vuong.

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All authors declare that they have no conflict of interest.

Ethical Standards Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration.

Statement of Informed Consent

Informed consent was obtained from all patients for being included in the study.

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Trung, L.V., Loc, N.V.V., Tien, T.P.D. et al. Laparoscopic Proximal Gastrectomy with Jejunal Interposition for Early Proximal Gastric Cancer. J Gastrointest Canc 52, 536–541 (2021). https://doi.org/10.1007/s12029-020-00420-0

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  • DOI: https://doi.org/10.1007/s12029-020-00420-0

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