Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Clinical Comparison of Proximal Gastrectomy With Double-Tract Reconstruction Versus Total Gastrectomy With Roux-en-Y Anastomosis for Siewert Type II/III Adenocarcinoma of the Esophagogastric Junction

  • Ma, Xiaoming (Department of General Surgery, The Second Affiliated Hospital of Soochow University) ;
  • Zhao, Mingzuo (Department of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University) ;
  • Wang, Jian (Department of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University) ;
  • Pan, Haixing (Department of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University) ;
  • Wu, Jianqiang (Department of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University) ;
  • Xing, Chungen (Department of General Surgery, The Second Affiliated Hospital of Soochow University)
  • Received : 2022.03.27
  • Accepted : 2022.06.07
  • Published : 2022.07.31
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Abstract

Purpose: The incidence of adenocarcinoma of the esophagogastric junction (AEG) has increased in recent years, and the optimal surgical strategy for AEG remains highly controversial. We aimed to evaluate the safety and efficacy of proximal gastrectomy with double-tract reconstruction (PG-DT) for the treatment of patients with AEG. Materials and Methods: We retrospectively analyzed patients with Siewert type II/III AEG between January 2013 and July 2018. Clinicopathological characteristics, survival, surgical outcomes, quality of life (QOL), and nutritional status were compared between the PG-DT and total gastrectomy with Roux-en-Y anastomosis (TG-RY) groups. Results: After propensity score matching, 33 patients in each group were analyzed. There were no statistical differences between the 2 groups in terms of disease-free survival and overall survival. The surgical option was not an independent prognostic factor based on the multivariate analysis. In addition, no differences were found in terms of surgical complications. There were no significant differences in QOL assessed by the Visick grade, Gastrointestinal Symptom Rating Scale, or endoscopic findings. Furthermore, the long-term nutritional advantage of the PG-DT group was significantly greater than that of the TG-RY group. Conclusions: PG-DT is a safe and effective procedure for patients with local Siewert type II/III AEG, regardless of the TNM stage.

Keywords

Acknowledgement

This study was funded by the Suqian Sci & Tech Program (grant No. K202005) and the Young Sci & Tech Talent Support Project of the Jiangsu Sci & Tech Association.

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