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 have been a great concern in recent years. This study aimed to compare the short-term and long-term outcomes between patients who underwent esophagogastrostomy (EG) and those who underwent 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 the DTR group was significantly longer than that of the EG group, there were no significant differences in postoperative complications between 2 groups. Regarding the endoscopic findings, the incidence of anastomotic stenosis and reflux esophagitis was significantly 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 significant 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.
CONCLUSIONS: DTR after PG could prevent the occurrence of anastomotic complications in comparison to EG. The long-term outcomes were similar between these 2 types of reconstruction.
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 the DTR group was significantly longer than that of the EG group, there were no significant differences in postoperative complications between 2 groups. Regarding the endoscopic findings, the incidence of anastomotic stenosis and reflux esophagitis was significantly 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 significant 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.
CONCLUSIONS: DTR after PG could prevent the occurrence of anastomotic complications in comparison to EG. The long-term outcomes were similar between these 2 types of reconstruction.
摘要：
背景：随着上三胃早期胃癌的近端胃切除术（PG）的机会不断增加，PG的安全性和可行性近年来一直备受关注。这项研究旨在比较接受食管胃造口术（EG）的患者和接受PG术后双道重建（DTR）的患者的短期和长期结果。
方法：我们回顾性回顾了2011年至2022年在我院接受EG治疗的34例患者和接受DTR治疗的39例患者的病历。我们比较了手术数据和术后并发症，包括术后1年内吻合口并发症，作为短期结局和营养状况的变化率，骨骼肌质量，和3年生存率作为长期结果。
结果：尽管DTR组的手术时间明显长于EG组，两组患者术后并发症差异无统计学意义。关于内窥镜检查结果，EG组吻合口狭窄和反流性食管炎的发生率明显高于DTR组（26.5％vs0％，p<0.001；15.2%对0%，p=0.020)。在长期结果中，体重没有显著差异，BMI,实验室数据,两组间的骨骼肌质量指数为3年。两组的3年总生存率相似。
结论：与EG相比，PG后DTR可以预防吻合口并发症的发生。这两种类型的重建的长期结果相似。
方法：我们回顾性回顾了2011年至2022年在我院接受EG治疗的34例患者和接受DTR治疗的39例患者的病历。我们比较了手术数据和术后并发症，包括术后1年内吻合口并发症，作为短期结局和营养状况的变化率，骨骼肌质量，和3年生存率作为长期结果。
结果：尽管DTR组的手术时间明显长于EG组，两组患者术后并发症差异无统计学意义。关于内窥镜检查结果，EG组吻合口狭窄和反流性食管炎的发生率明显高于DTR组（26.5％vs0％，p<0.001；15.2%对0%，p=0.020)。在长期结果中，体重没有显著差异，BMI,实验室数据,两组间的骨骼肌质量指数为3年。两组的3年总生存率相似。
结论：与EG相比，PG后DTR可以预防吻合口并发症的发生。这两种类型的重建的长期结果相似。
