The curative effect and postoperative observation on the treatment of upper gastric cancer by proximal gastrectomy with double tract anastomosis
MENG Jinying;WANG Qingshi;CHEN Honghong;WANG Hua;SHI Dawei;LIU Yongcun;MA Ning;Department of Surgical Oncology,the First People's Hospital of Xianyang;
Objective To observe the curative effect of proximal gastrectomy with double tract anastomosis of esophagojejunal anastomosis or gastrojejunostomy in the treatment of upper gastric cancer. Method 41 cases of upper gastric cancer patients who were given proximal gastrectomy combined with esophagojejunal anastomosis or gastrojejunostomy as double tract anastomosis(double tract anastomosis group) and another 41 cases who were administered with conventional radical gastrectomy combined with esophagojejunostomy Roux-en-Y anastomosis were included as control(conventional therapy group). The surgery related measures(operative time, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay), postoperative complications(dumping syndrome, reflux esophagitis, postoperative bleeding, postoperative obstruction, anastomosis fistula/stricture, gastroparesis), nutritional status 1 year after surgery(total plasma protein, plasma albumin, hemoglobin and weight loss) and quality of life, postoperative survival in 3 years after surgery were observed. Result The operative time of the double tract anastomosis group was longer than that of the conventional therapy group, and the intraoperative blood loss, postoperative exhaust time and hospital stay were less than those of the conventional therapy group, showing statistically significant difference(P0.01). The incidence of dumping syndrome and reflux esophagitis were lower in double tract anastomosis group than that of conventional therapy group,with statistically significant difference observed(P0.05). In 1 year after surgery, the total plasma protein, plasma albumin, and hemoglobin, as well as SF-36 score were better in double tract anastomosis group than in conventional therapy group, and the weight loss was less than that in those who received conventional therapy(P0.05); in 3 years after surgery, the survival rate in the double tract anastomosis group was 97.6%, which was higher than the 85.4% in the conventional therapy group, and the difference was statistically significant(χ2=3.977, P=0.046). Conclusion The curative effect of proximal gastrectomy with double tract anastomosis is fair in the treatment of upper gastric cancer, with reduced incidence of postoperative complications, improving the quality of life and nutritional status, as well as long-term survival for patients, and is clinically applicable.
【CateGory Index】： R735.2