Modified Double-tract Reconstruction in Terms of Postoperative Quality of Life in Patients With Early Esophagogastirc Junction Adenocarcinoma After Proximal Gastrectomy

Abstract

Background Increased reflux symptoms limited clinical application of proximal gastrectomy (PG) in the patients with early adenocarcinoma of esophagogastirc junction (AEG). The purpose of this study is to describe a method of modified double-tract reconstruction (DTR) after PG, and to evaluate the feasibility, safety, surgical outcomes, postoperative gut function and nutritional status post operation. Methods Prospective cohort data of 25 patients with early AEG who presented to a single tertiary hospital from Jan 2019 to Jun2019 and underwent DTR after PG were analyzed respectively. The data of this prospective cohort included: clinicopathologic characteristics, surgical outcomes, time to first flatus and defecation, Visick Score, degrees and extent of remnant gastritis, Los Angles Classification in 1-year follow-up.Results The mean operation time was 206.54±75.44 min; estimated blood loss was 128.85±48.38 ml; length of proximal and distal resection margin were 2.53±0.83 and 4.86±1.49 cm; and number of retrieved lymph nodes reached 23.54±8.04. The postoperative complication rate was 8% (n = 2), which were both treated by conservative management. The postoperative gut function improved gradually and the volume of postoperative daily intake could reach over 700ml on 6th POD. The levels of albumin and prealbumin returned to normal status and weight loss also remained steadily at 3-month after operation. The rate of reflux symptoms was 12% (n = 3), which were classified as Visick grade II at 1-year follow-up after operation. ConclusionThe short-term outcome of this modified DTR was satisfied, which could improve the nutrition status and quality of life post operation.Trial registrationChiCTR, ChiCTR 1900024826. Registered 29 July 2019. https://www.chictr.org.cn/searchproj.aspx?title=&officialname=&subjectid=&secondaryid=&applier=&studyleader=&ethicalcommitteesanction=&sponsor=&studyailment=&studyailmentcode=&studytype=0&studystage=0&studydesign=0&minstudyexecutetime=&maxstudyexecutetime=&recruitmentstatus=0&gender=0&agreetosign=&secsponsor=&regno=ChiCTR1900024826&regstatus=0&country=&province=&city=&institution=&institutionlevel=&measure=&intercode=&sourceofspends=&createyear=0&isuploadrf=&whetherpublic=&btngo=btn&verifycode=&page=1