Comparison of laparoscopic proximal gastrectomy with double-tract reconstruction and laparoscopic total gastrectomy in terms of nutritional status or quality of life in early gastric cancer patients

Park, Ji Yeon; Park, Ki Bum; Kwon, Oh Kyoung; Yu, Wansik

doi:10.1016/j.ejso.2018.08.014

Cited by 62 publications

(75 citation statements)

References 33 publications

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“…In previous studies, the double-tract reconstruction had better outcomes in laboratory ndings related to iron de ciency anemia and vitamin B12 de ciency compared to total gastrectomy. [13,26] Moreover, the nutritional outcomes of the DTR group were similar to those of the EG group in this study. Therefore, DTR can be a favorable option after laparoscopic proximal gastrectomy.…”

Section: Discussionsupporting

confidence: 75%

“…[27,28] On the other hand, the EG method, including jejunal interposition and doubletract reconstruction, had no long-term bene t in QOL compared with total gastrectomy. [13,29] In this study, we expected some differences in the re ux and dysphagia subscales related to anastomotic complications; however, there was no signi cant difference between the two groups. It is possible that some patients with re ux esophagitis in the EG group only had mild symptoms, or their symptoms were well controlled by a proton-pump inhibitor.…”

Section: Discussionmentioning

confidence: 70%

“…In particular, nutritional outcomes were better in proximal gastrectomy compared with total gastrectomy. [8,12,13] However, few studies have compared functional outcomes between the two types of reconstruction (EG vs. esophagojejunostomy) after laparoscopic proximal gastrectomy.…”

Section: Introductionmentioning

confidence: 99%

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Comparison Of Nutrition And Quality Of Life Of Esophagogastrostomy And The Double-Tract Reconstruction After Laparoscopic Proximal Gastrectomy

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Park

et al. 2020

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Purpose: This study aims to compare the nutritional outcomes and quality of life between patients who underwent esophagogastrostomy (EG) and those who underwent the double-tract reconstruction (DTR) after laparoscopic proximal gastrectomy for early gastric cancer.Methods: We retrospectively reviewed the prospectively established database of 45 patients who underwent EG with anti-reflux procedure and 58 patients who underwent the DTR after laparoscopic proximal gastrectomy between December 2013 and June 2017. Then, we compared the baseline characteristics, clinical outcomes, postoperative nutritional parameters, and quality of life (QOL) using EORTC QLQ STO-22 between the EG and DTR groups. Results: In the postoperative 1-year endoscopic findings, the incidence of esophageal reflux was higher in the EG group (17.8% vs. 3.4%, p=0.041) and there was no significant difference in anastomotic stricture. Nutritional status was assessed via body mass index, serum albumin, protein, hemoglobin, and ferritin; we found no significant differences. The incidences of iron deficiency anemia and vitamin B12 deficiency also showed no significant difference between the two groups. With regards to the quality of life, the difference values between preoperative and postoperative 1-year were evaluated; there was no significant difference between the EG with anti-reflux procedure and DTR groups. Conclusions: EG had higher incidence of esophageal reflux and similar nutritional outcomes and QOL compared with the double-tract reconstruction after laparoscopic proximal gastrectomy. Additional large-scale research is needed to evaluate the long-term functional outcomes of EG and the double-tract reconstruction.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 70%

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Comparison Of Nutrition And Quality Of Life Of Esophagogastrostomy And The Double-Tract Reconstruction After Laparoscopic Proximal Gastrectomy

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Park

et al. 2020

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“…In view of another approach, the double tract reconstruction could reduce the incidence of reflux esophagitis and retained the gastric reservoir and duodenal passage, but the procedure was a little complicated and need more reconstruction time. Moreover, the volume function of residual stomach has not been fully developed because most of the ingested food did not pass through the gastric bypass, and the bile reflux gastritis had not been significantly reduced [30][31][32][33]. Similarly, our practices have showed that patients with DT also have apparently reflux symptoms and a relatively high incidence of bile reflux gastritis, which has a negative impact on their quality of life.…”

Section: Discussionmentioning

confidence: 87%

Novel Reconstruction Using Roux-en-Y Plus Antral Obstruction Following Proximal Gastrectomy: Feasibility and Quality of Life Benefits

Dejun¹,

Wang²,

Fu³

et al. 2019

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Background and Aims Routine gastroesophagostomy has been shown to have adverse effects on the recovery of digestive functions and quality of life because patients typically experience reflux symptoms after proximal gastrectomy. This study was performed to assess the feasibility and quality of life benefits of a novel reconstruction method termed Roux-en-Y anastomosis plus antral obstruction (RYAO) following proximal partial gastrectomy. Methods A total of 73 patients who underwent proximal gastrectomy from June 2015 to June 2017 were divided into two groups according to digestive reconstruction methods [RYAO (37 patients) and conventional esophagogastric anastomosis with pyloroplasty (EGPP, 36 patients)]. Clinical data were compared between the two groups retrospectively. Results The mean operative time for digestive reconstruction was slightly longer in the RYAO group than in the EGPP group. However, the incidence of postoperative short-term complications did not differ between the RYAO and the EGPP groups. At the 6-month follow-up, the incidence rates of both reflux esophagitis and gastritis were lower in the RYAO group than in the EGPP group (P = 0.002). Additionally, body weight recovery was better in the RYAO group (P = 0.028). The scale tests indicated that compared with the patients in the EGPP group, the patients in the RYAO group had significantly reduced reflux, nausea and vomiting and reported improvements in their overall health status and quality of life (all P < 0.05). Conclusion RYAO reconstruction may be a feasible procedure to reduce postoperative reflux symptoms and the incidence of reflux esophagitis and gastritis, thus improving patient quality of life after proximal gastrectomy.

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“…After screening the title and abstract, 49 studies were evaluated via full-text articles. At last, seven articles [7,[12][13][14][15][16][17] published were included for quantitative synthesis from 2016 to 2018. The flow diagram were summarized is shown in Fig.…”

Section: Literature Searchmentioning

confidence: 99%

A meta-analysis of comparison of proximal gastrectomy with double-tract reconstruction and total gastrectomy for proximal early gastric cancer

Shen

et al. 2019

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Background In theory, proximal gastrectomy with double-tract reconstruction (PG-DT) was superior to total gastrectomy (TG) in hematologic and nutritional outcomes. However, its clinical effects in proximal early gastric cancer (EGC) have been controversial. Methods The purpose of this study was to investigate the outcomes of laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DT) for proximal EGC. For this systematic review and meta-analysis, we searched for articles published before December of 2018 in the following databases: PubMed, Web of Science, EBSCO, Medline, and Cochrane Library. Results The results showed no significant difference in the anastomotic stenosis (OR=0.91, 95%CI=0.33-2.50, p=0.85) and reflux esophagitis (OR=1.87, 95%CI=0.62-5.65, p=0.27) between LPG-DT and laparoscopic total gastrectomy (LTG). The vitamin B12 supplementation rate in the LPG-DT group was lower than the LTG group (OR=0.06, 95%Cl=0.01-0.59, p=0.02). Conclusions Due to comparable clinical effect, PG-DT is comparable to TG for patients with proximal EGC. In addition, LPG-DT not only appears superior to TG in terms of preventing vitamin B12 deficiency, but also does not increase the risk of anastomotic stricture and reflux esophagitis.

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Comparison of laparoscopic proximal gastrectomy with double-tract reconstruction and laparoscopic total gastrectomy in terms of nutritional status or quality of life in early gastric cancer patients

Cited by 62 publications

References 33 publications

Comparison Of Nutrition And Quality Of Life Of Esophagogastrostomy And The Double-Tract Reconstruction After Laparoscopic Proximal Gastrectomy

Comparison Of Nutrition And Quality Of Life Of Esophagogastrostomy And The Double-Tract Reconstruction After Laparoscopic Proximal Gastrectomy

Novel Reconstruction Using Roux-en-Y Plus Antral Obstruction Following Proximal Gastrectomy: Feasibility and Quality of Life Benefits

A meta-analysis of comparison of proximal gastrectomy with double-tract reconstruction and total gastrectomy for proximal early gastric cancer

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