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Clinical outcomes of gastric tube reconstruction following laparoscopic proximal gastrectomy for early gastric cancer in the upper third of the stomach: experience with 100 consecutive cases

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Abstract

Background

Gastric tube reconstruction is a form of esophagogastrostomy performed after laparoscopic proximal gastrectomy (LPG). It is a simple and safe technique, but it may cause reflux esophagitis (RE) and impair postsurgical QOL. For several years, we have developed the gastric tube reconstruction and performed it on more than 100 patients. This study aimed to determine whether gastric tube reconstruction can be a feasible choice after LPG in regard to surgical safety and postoperative nutritional status.

Methods

The subjects consisted of 171 patients who underwent LPG (n = 102) or laparoscopic total gastrectomy (LTG) (n = 69). We compared the two groups in terms of surgical outcomes, incidence rate of RE, and nutritional status including postoperative weight loss and hemoglobin levels.

Results

There were no significant differences with regard to the surgical duration and blood loss between the two groups. The incidence of RE was not significantly higher with LPG than with LTG (16.7% vs. 10.1%, respectively; P = 0.07). Later than 2 years and 6 months after surgery, the body weight percentage of preoperative body weight in the LPG group was significantly higher than that in the LTG group. Hemoglobin and ferritin levels in the LPG group were significantly higher than those in the LTG group, later than one after surgery. The overall survival rates were similar between the two groups (5-year survival rates: 97.1% vs. 94.2% in the LPG and LTG groups, respectively; P = 0.69).

Conclusions

Gastric tube reconstruction after LPG is simple and had better outcomes than LTG in terms of postoperative nutritional status.

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Authors and Affiliations

  1. Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda Kawagoe, Saitama, 350-8550, Japan

    Yoshitaka Toyomasu, Erito Mochiki, Toru Ishiguro, Tetsuya Ito, Okihide Suzuki, Youichi Kumagai, Keiichiro Ishibashi & Hideyuki Ishida

  2. Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan

    Yoshitaka Toyomasu, Kyoichi Ogata, Hiroshi Saeki & Ken Shirabe

Authors
  1. Yoshitaka Toyomasu
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  2. Erito Mochiki
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  3. Toru Ishiguro
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  4. Tetsuya Ito
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  5. Okihide Suzuki
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  6. Kyoichi Ogata
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  7. Youichi Kumagai
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  8. Keiichiro Ishibashi
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  9. Hiroshi Saeki
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  10. Ken Shirabe
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  11. Hideyuki Ishida
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Contributions

Study conception and design: Toyomasu Y and Mochiki E. Acquisition of data: Toyomasu Y, Ishiguro T, Ito T, Suzuki O, Ogata K, and Mochiki E. Analysis and interpretation of data: Toyomasu Y, Kumagai Y, Ishibashi K, and Saeki H. Drafting of manuscript: Toyomasu Y and Ishida H. Critical revision: Shirabe K and Ishida H

Corresponding author

Correspondence to Yoshitaka Toyomasu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Toyomasu, Y., Mochiki, E., Ishiguro, T. et al. Clinical outcomes of gastric tube reconstruction following laparoscopic proximal gastrectomy for early gastric cancer in the upper third of the stomach: experience with 100 consecutive cases. Langenbecks Arch Surg 406, 659–666 (2021). https://doi.org/10.1007/s00423-021-02132-w

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