Effects of proximal gastrectomy with narrow gastric tube anastomosis compared with total gastrectomy with Roux-en-Y anastomosis on upper gastric cancer

• Published in: Langenbeck's archives of surgery Vol. 408; no. 1; p. 141
• Main Authors: Wang, Zhuo-Yin, Wang, Jing-Tao, Li, Rui-Xin, Wang, Guo-Jun, Zhu, Tian-Yu, Gao, Bu-Lang
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 05.04.2023
• Subjects: Abdominal Surgery; Albumins; Anastomosis, Roux-en-Y - methods; Anastomosis, Surgical - methods; Brief Report; Cardiac Surgery; Constriction, Pathologic - surgery; Gastrectomy - adverse effects; General Surgery; Hemoglobins; Humans; Medicine; Medicine & Public Health; Postoperative Complications - epidemiology; Stomach Neoplasms - surgery; Thoracic Surgery; Traumatic Surgery; Treatment Outcome; Vascular Surgery; Upper gastric cancer; Narrow gastric tube anastomosis; Total gastrectomy; Roux-en-Y anastomosis; Proximal gastrectomy
• ISSN: 1435-2451; 1435-2451
• DOI: 10.1007/s00423-023-02878-5

Objective To investigate the clinical efficacy of proximal gastrectomy with narrow gastric tube anastomosis (PG-NGT) and total gastrectomy with Roux-en-Y anastomosis (TG-RY) for upper gastric cancer. Materials and methods One hundred sixty-three upper gastric cancer patients were enrolled into the PG-NGT group and TG-RY group. The propensity score matching method was used to conduct a one-to-one match between the two groups with 38 patients in each group. Results Compared with the TG-RY group, the PG-NGT group had significantly ( P < 0.05) shorter operation time, shorter hospital stay, and less intraoperative blood loss. The TG-RY group had significantly ( P = 0.009) more lymph nodes dissected and greater ( P = 0.014) total cost than the PG-NGT group, but no significant difference existed in the surgical cost between the two groups ( P = 0.214). There was no significant ( P > 0.05) difference in the incidence of anastomotic stenosis (10.5% vs. 13.1%) or the reflux esophagitis rate (8.6% vs. 9.1%) in the PG-NGT group and the TG-RY group. One year after surgery, the weight and hemoglobin and albumin levels in the PG-NGT group were significantly ( P < 0.05) higher than those in the TG-RY group. Conclusions PG-NGT may be better than TG-RY in improving patient weight loss and hemoglobin and albumin levels, without increasing the rate of anastomotic stenosis and reflux symptoms.