Comparison of perioperative and long-term outcomes of total and proximal gastrectomy for early gastric cancer: A multi-institutional retrospective study

Toru Masuzawa, Shuji Takiguchi, Motohiro Hirao, Hiroshi Imamura, Yutaka Kimura, Junya Fujita, Isao Miyashiro, Shigeyuki Tamura, Masahiro Hiratsuka, Kenji Kobayashi, Yoshiyuki Fujiwara, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

28 Citations (Scopus)

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 languageEnglish
Pages (from-to)1100-1106
Number of pages7
JournalWorld journal of surgery
Volume38
Issue number5
DOIs
Publication statusPublished - May 2014

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Gastrectomy
Stomach Neoplasms
Retrospective Studies
Weight Loss
Stomach
Dumping Syndrome
Patient Transfer
Heartburn
Operative Time
Serum Albumin
Medical Records
Diarrhea
Length of Stay
Emotions
Hemoglobins
Adenocarcinoma
Survival

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 journalArticle

Masuzawa, T, Takiguchi, S, Hirao, M, Imamura, H, Kimura, Y, Fujita, J, Miyashiro, I, Tamura, S, Hiratsuka, M, Kobayashi, K, Fujiwara, Y, Mori, M & Doki, Y 2014, 'Comparison of perioperative and long-term outcomes of total and proximal gastrectomy for early gastric cancer: A multi-institutional retrospective study', World journal of surgery, vol. 38, no. 5, pp. 1100-1106. https://doi.org/10.1007/s00268-013-2370-5
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. / Comparison of perioperative and long-term outcomes of total and proximal gastrectomy for early gastric cancer : A multi-institutional retrospective study. In: World journal of surgery. 2014 ; Vol. 38, No. 5. pp. 1100-1106.
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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.",
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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.

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