Abstract
Background: Various surgical procedures are used to treat early gastric cancers in the upper third of the stomach (U-EGCs). However, there is no general agreement regarding the optimal surgical procedure. Methods: The medical records of 203 patients with U-EGC were collected from 13 institutions. Surgical procedures were classified as Roux-en-Y esophagojejunostomy after total gastrectomy (TG-RY), esophagogastrostomy after proximal gastrectomy (PG-EG), or jejunal interposition after PG (PG-JI). Patient clinical characteristics and perioperative and long-term outcomes were compared among these three groups. Results: TG-RY, PG-EG, and PG-JI were performed in 122, 49, and 32 patients, respectively. Tumors were larger in TG-RY patients than in PG-EG and PG-JI patients, and undifferentiated-type gastric adenocarcinoma tended to be more frequent in TG-RY than in PG-EG. The operative time was shorter for PG-EG than for PG-JI and TG-RY. Hospital stay and early postoperative complications were not different for the three procedures. With respect to gastrectomy-associated symptoms, a "stuck feeling" and heartburn tended to be more frequent in PG-EG patients, while dumping syndrome and diarrhea were more frequent in TG-RY patients. Post-surgical weight loss was not different among the three groups, however, serum albumin and hemoglobin levels tended to be lower in TG-RY patients. Conclusion: Three surgical procedures for U-EGC did not result in differences in weight loss, but PG-EG and PG-JI were better than TG-RY according to some nutritional markers. In U-EGC, where patients are expected to have long survival times, PG-EG and PG-JI should be used rather than TG-RY.
| Original language | English |
|---|---|
| Pages (from-to) | 1100-1106 |
| Number of pages | 7 |
| Journal | World journal of surgery |
| Volume | 38 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2014 |
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All Science Journal Classification (ASJC) codes
- Surgery
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Comparison of perioperative and long-term outcomes of total and proximal gastrectomy for early gastric cancer : A multi-institutional retrospective study. / Masuzawa, Toru; Takiguchi, Shuji; Hirao, Motohiro; Imamura, Hiroshi; Kimura, Yutaka; Fujita, Junya; Miyashiro, Isao; Tamura, Shigeyuki; Hiratsuka, Masahiro; Kobayashi, Kenji; Fujiwara, Yoshiyuki; Mori, Masaki; Doki, Yuichiro.
In: World journal of surgery, Vol. 38, No. 5, 05.2014, p. 1100-1106.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of perioperative and long-term outcomes of total and proximal gastrectomy for early gastric cancer
T2 - A multi-institutional retrospective study
AU - Masuzawa, Toru
AU - Takiguchi, Shuji
AU - Hirao, Motohiro
AU - Imamura, Hiroshi
AU - Kimura, Yutaka
AU - Fujita, Junya
AU - Miyashiro, Isao
AU - Tamura, Shigeyuki
AU - Hiratsuka, Masahiro
AU - Kobayashi, Kenji
AU - Fujiwara, Yoshiyuki
AU - Mori, Masaki
AU - Doki, Yuichiro
PY - 2014/5
Y1 - 2014/5
N2 - Background: Various surgical procedures are used to treat early gastric cancers in the upper third of the stomach (U-EGCs). However, there is no general agreement regarding the optimal surgical procedure. Methods: The medical records of 203 patients with U-EGC were collected from 13 institutions. Surgical procedures were classified as Roux-en-Y esophagojejunostomy after total gastrectomy (TG-RY), esophagogastrostomy after proximal gastrectomy (PG-EG), or jejunal interposition after PG (PG-JI). Patient clinical characteristics and perioperative and long-term outcomes were compared among these three groups. Results: TG-RY, PG-EG, and PG-JI were performed in 122, 49, and 32 patients, respectively. Tumors were larger in TG-RY patients than in PG-EG and PG-JI patients, and undifferentiated-type gastric adenocarcinoma tended to be more frequent in TG-RY than in PG-EG. The operative time was shorter for PG-EG than for PG-JI and TG-RY. Hospital stay and early postoperative complications were not different for the three procedures. With respect to gastrectomy-associated symptoms, a "stuck feeling" and heartburn tended to be more frequent in PG-EG patients, while dumping syndrome and diarrhea were more frequent in TG-RY patients. Post-surgical weight loss was not different among the three groups, however, serum albumin and hemoglobin levels tended to be lower in TG-RY patients. Conclusion: Three surgical procedures for U-EGC did not result in differences in weight loss, but PG-EG and PG-JI were better than TG-RY according to some nutritional markers. In U-EGC, where patients are expected to have long survival times, PG-EG and PG-JI should be used rather than TG-RY.
AB - Background: Various surgical procedures are used to treat early gastric cancers in the upper third of the stomach (U-EGCs). However, there is no general agreement regarding the optimal surgical procedure. Methods: The medical records of 203 patients with U-EGC were collected from 13 institutions. Surgical procedures were classified as Roux-en-Y esophagojejunostomy after total gastrectomy (TG-RY), esophagogastrostomy after proximal gastrectomy (PG-EG), or jejunal interposition after PG (PG-JI). Patient clinical characteristics and perioperative and long-term outcomes were compared among these three groups. Results: TG-RY, PG-EG, and PG-JI were performed in 122, 49, and 32 patients, respectively. Tumors were larger in TG-RY patients than in PG-EG and PG-JI patients, and undifferentiated-type gastric adenocarcinoma tended to be more frequent in TG-RY than in PG-EG. The operative time was shorter for PG-EG than for PG-JI and TG-RY. Hospital stay and early postoperative complications were not different for the three procedures. With respect to gastrectomy-associated symptoms, a "stuck feeling" and heartburn tended to be more frequent in PG-EG patients, while dumping syndrome and diarrhea were more frequent in TG-RY patients. Post-surgical weight loss was not different among the three groups, however, serum albumin and hemoglobin levels tended to be lower in TG-RY patients. Conclusion: Three surgical procedures for U-EGC did not result in differences in weight loss, but PG-EG and PG-JI were better than TG-RY according to some nutritional markers. In U-EGC, where patients are expected to have long survival times, PG-EG and PG-JI should be used rather than TG-RY.
UR - http://www.scopus.com/inward/record.url?scp=84898848264&partnerID=8YFLogxK
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U2 - 10.1007/s00268-013-2370-5
DO - 10.1007/s00268-013-2370-5
M3 - Article
C2 - 24310733
AN - SCOPUS:84898848264
VL - 38
SP - 1100
EP - 1106
JO - World Journal of Surgery
JF - World Journal of Surgery
SN - 0364-2313
IS - 5
ER -