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Study of Short-Term and Long-Term Outcomes Between Esophagogastrostomy and Double-Tract Reconstruction After Proximal Gastrectomy

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Abstract

Background

As the opportunities for proximal gastrectomy (PG) for early gastric cancer in the upper third stomach have been increasing, the safety and feasibility of PG have been a great concern in recent years. This study aimed to compare the short-term and long-term outcomes between patients who underwent esophagogastrostomy (EG) and those who underwent double-tract reconstruction (DTR) after PG.

Methods

We retrospectively reviewed the medical records of 34 patients who underwent EG and 39 who underwent DTR at our hospital between 2011 and 2022. We compared the procedure data and postoperative complications including anastomotic complications within 1 year after surgery as short-term outcomes and the rates of change in nutritional status, skeletal muscle mass, and 3-year survival as long-term outcomes.

Results

Although operation time of the DTR group was significantly longer than that of the EG group, there were no significant differences in postoperative complications between 2 groups. Regarding the endoscopic findings, the incidence of anastomotic stenosis and reflux esophagitis was significantly higher in the EG group than in the DTR group (26.5% vs 0%, p < 0.001; 15.2% vs 0%, p = 0.020). In long-term outcomes, there were no significant differences in body weight, BMI, laboratory data, and skeletal muscle mass index between 2 groups for 3 years. The 3-year overall survival rates of 2 groups were similar.

Conclusion

DTR after PG could prevent the occurrence of anastomotic complications in comparison to EG. The long-term outcomes were similar between these 2 types of reconstruction.

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Data Availability

No datasets were generated or analyzed during the current study.

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Acknowledgements

The authors thank Mr. Brian Quinn of Japan Medical Communication (www.japan-mc.co.jp) for editing the draft of this article.

Funding

This work was not supported by any funding.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan

    Tsuyoshi Hasegawa, Naoshi Kubo, Katsunobu Sakurai, Junya Nishimura, Yasuhito Iseki, Takafumi Nishii, Sadatoshi Shimizu, Toru Inoue & Yukio Nishiguchi

  2. Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan

    Kiyoshi Maeda

Authors
  1. Tsuyoshi Hasegawa
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  2. Naoshi Kubo
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  3. Katsunobu Sakurai
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by T.H., N.K., and K.S. The first draft of the manuscript was written by T.H. N.K. and K.S. commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tsuyoshi Hasegawa.

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Ethics Approval

The protocol for this study was approved by the Ethic Committee of the study center (Osaka City General Hospital, Approval No. 1806031) and complies with the Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all the participants.

Competing Interests

The authors declare no competing interests.

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Hasegawa, T., Kubo, N., Sakurai, K. et al. Study of Short-Term and Long-Term Outcomes Between Esophagogastrostomy and Double-Tract Reconstruction After Proximal Gastrectomy. J Gastrointest Canc (2024). https://doi.org/10.1007/s12029-024-01050-6

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