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Similar hematologic and nutritional outcomes after proximal gastrectomy with double-tract reconstruction in comparison to total gastrectomy for early upper gastric cancer

Surgical Endoscopy volume 33, pages 1757–1768 (2019)Cite this article

Abstract

Background

Proximal gastrectomy offers theoretical benefits over total gastrectomy in terms of hematologic and nutritional outcomes. However, little evidence confirming these benefits has been reported. The aim of this study was to assess the hematologic and nutritional outcomes of proximal gastrectomy with double-tract reconstruction in comparison to those of total gastrectomy.

Methods

We retrospectively analyzed data from 80 patients with stage I gastric cancer who underwent proximal gastrectomy with double-tract reconstruction (n = 38) or total gastrectomy (n = 42) from September 2014 to December 2015. We compared hematologic (including hemoglobin, ferritin, vitamin B12, etc.) and nutritional outcomes [including body mass index (BMI), serum total protein, albumin, total cholesterol, and total lymphocyte count] between the two groups.

Results

We found no significant differences in changes in hemoglobin (P = 0.250) or cumulative incidence of iron deficiency anemia (P = 0.971) during a median follow-up period of 24 months (range 18–30 months) after surgery. Cumulative incidence of vitamin B12 deficiency also did not differ significantly between the proximal and total gastrectomy groups (P = 0.087). BMI changes from baseline were not significantly different between the two groups (P = 0.591). Likewise, there were no statistically significant differences in nutritional outcomes.

Conclusions

Proximal gastrectomy with double-tract reconstruction exhibited similar outcomes in terms of hematologic and nutritional features in comparison to total gastrectomy.

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Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea

    Minah Cho, Taeil Son, Hyoung-Il Kim, Sung Hoon Noh, Seohee Choi, Won Jun Seo, Chul Kyu Roh & Woo Jin Hyung

  2. Gastric Cancer Center, Yonsei Cancer Center, Seoul, South Korea

    Taeil Son, Hyoung-Il Kim, Sung Hoon Noh & Woo Jin Hyung

  3. Robot and Minimally Invasive Surgery Center, Severance Hospital, Seoul, South Korea

    Taeil Son, Hyoung-Il Kim & Woo Jin Hyung

Authors
  1. Minah Cho
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  2. Taeil Son
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  3. Hyoung-Il Kim
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  4. Sung Hoon Noh
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  5. Seohee Choi
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  6. Won Jun Seo
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  8. Woo Jin Hyung
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Corresponding author

Correspondence to Woo Jin Hyung.

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Disclosures

Minah Cho, Taeil Son, Hyoung-Il Kim, Sung Hoon Noh, Seohee Choi, Won Jun Seo, Chul Kyu Roh, and Woo Jin Hyung have no conflicts of interest or financial ties to disclose.

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Cho, M., Son, T., Kim, HI. et al. Similar hematologic and nutritional outcomes after proximal gastrectomy with double-tract reconstruction in comparison to total gastrectomy for early upper gastric cancer. Surg Endosc 33, 1757–1768 (2019). https://doi.org/10.1007/s00464-018-6448-x

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  • DOI: https://doi.org/10.1007/s00464-018-6448-x

Keywords

  • Proximal gastrectomy
  • Double-tract reconstruction
  • Total gastrectomy
  • Anemia
  • Iron deficiency
  • Vitamin B12