World Journal of Surgery

, Volume 39, Issue 11, pp 2726–2733 | Cite as

Functional Advantages of Proximal Gastrectomy with Jejunal Interposition Over Total Gastrectomy with Roux-en-Y Esophagojejunostomy for Early Gastric Cancer

  • Masaki Ohashi
  • Shinji Morita
  • Takeo Fukagawa
  • Ichiro Oda
  • Ryoji Kushima
  • Hitoshi Katai
Original Scientific Report



The postoperative functional advantages of a proximal gastrectomy over a total gastrectomy remain debatable. The aim of this study was to evaluate the functional outcomes of a proximal gastrectomy with jejunal interposition (PG-JI), compared with those for a total gastrectomy with Roux-en-Y esophagojejunostomy (TG-RY), in patients with early gastric cancer.


Between 2007 and 2012, 65 patients underwent PG-JI and 117 underwent TG-RY for cT1 gastric cancer. Various parameters, including body weight, serum hemoglobin level, and interview-based symptoms, were prospectively evaluated in these patients. In patients who underwent PG-JI, the postoperative endoscopic findings were also assessed.


All the surgeries were performed via a laparotomy alone. During a median postoperative follow-up of 42 months (range, 12–78 months), PG-JI offered significant reductions in body weight loss (12.5 ± 5.8 vs. 17.4 ± 6.4 %, P < 0.001), serum hemoglobin decline (7.0 ± 5.7 vs. 9.7 ± 5.4 %, P = 0.002), and dumping symptoms (11 % [7/65] vs. 30 % [35/117], P = 0.003), while being associated with similar incidences of anastomotic stricture (9 % [6/65] vs. 8 % [9/117], P = 0.781), small bowel obstruction (0 % [0/65] vs. 2 % [2/117], P = 0.538), stasis symptoms (51 % [33/65] vs. 44 % [51/117], P = 0.358), and reflux symptoms (34 % [22/65] vs. 23 % [27/117], P = 0.121), compared with TG-RY. Four cases of gastric remnant cancer and no cases of endoscopic reflux esophagitis were found after PG-JI.


PG-JI has clear functional advantages over TG-RY, although it requires active surveillance for remnant gastric cancer.


Grant support


Compliance with ethical standards

Conflicts of interest



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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Masaki Ohashi
    • 1
  • Shinji Morita
    • 1
  • Takeo Fukagawa
    • 1
  • Ichiro Oda
    • 2
  • Ryoji Kushima
    • 3
  • Hitoshi Katai
    • 1
  1. 1.Gastric Surgery DivisionNational Cancer Center HospitalTokyoJapan
  2. 2.Endoscopy DivisionNational Cancer Center HospitalTokyoJapan
  3. 3.Pathology DivisionNational Cancer Center HospitalTokyoJapan

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