Study of Short-Term and Long-Term Outcomes Between Esophagogastrostomy and Double-Tract Reconstruction After Proximal Gastrectomy

Abstract

Background.As the opportunities for proximal gastrectomy (PG) for early gastric cancer in the upper third stomach have been increasing, the safety and feasibility of PG has been a great concern in recent years. This study aimed to compare to the short-term and long-term outcomes between patients who underwent esophagogastrostomy (EG) and those who underwent the double-tract reconstruction (DTR) after PG. Methods.We retrospectively reviewed the medical records of 34 patients who underwent EG and 39 who underwent DTR at our hospital between 2011 and 2022. We compared the procedure data and postoperative complications including anastomotic complications within 1 year after surgery as short-term outcomes, and the rates of change in nutritional status, skeletal muscle mass, and 3-year survival as long-term outcomes. Results.Although operation time of DTR group was signi cantly longer than that of EG group, there were not signi cantly differences in postoperative complications between 2 groups. Regarding the endoscopic ndings, the incidence of anastomotic stenosis and re ux esophagitis was signi cantly higher in the EG group than in the DTR group (26.5% vs 0%; p < 0.001, 15.2% vs 0%; p = 0.020). In long-term outcomes, there were no signi cant differences in body weight, BMI, laboratory data, and skeletal muscle mass index between 2 groups for 3 years. The 3-year overall survival rates of 2 groups were similar. Conclusion.DTR after PG could prevent the occurrence of anastomotic complications in comparison to EG. The longterm outcomes were similar between these 2 types of reconstruction.