20240208 Comparison of clinical efficacy between laparoscopic total gastrectomy and proximal gastrectomy in the treatment of adenocarcinoma of esophagogastric junction http://zglcyj.ijournals.cn/zglcyj/ch/reader/create_pdf.aspx?file_no=20240208 10.13429/j.cnki.cjcr.2024.02.008 DAI Dezhu, SHI Jin, SONG Xudong, DING Fan, TAO Guoquan Department of Gastrointestinal Surgery, The Affiliated Huai ‘an No.1 People ‘s Hospital of Nanjing Medical University, Huai ‘an，Jiangsu 223300, China Objective To compare the advantages and disadvantages of two different resection margins by observing the clinical efficacy of laparoscopic total gastrectomy (TG) and proximal gastrectomy(PG) for radical resection of adenocarcinoma of esophagogastric junction (AEJ). Methods A total of 90 patients with AEJ who were treated by Huai ‘an No.1 People ‘s Hospital from January 2020 to December 2021 were retrospectively reviewed. Patients were divided into PG group ( n=43) and TG group ( n=47) according to the surgical resection range. The general data, surgery related statistical indicators of the two groups were compared. Results The TG group had a longer operation time than the PG group, with significantly more intraoperative blood loss and a greater number of intraoperatively cleared lymph nodes than the PG group (P＜0.05). There was no significant difference in terms of drainage volume of the abdominal drainage tubes in the 3day postoperative period, postoperative period to the drainage removal, the length of hospitalization, and postoperative complications between two groups (P>0.05). Postoperative levels of hemoglobin, albumin, and prealbumin were significant lower in TG group compared with those in PG group (P<0.05). The 1year overall survival rates for the PG group and TG group were 95.3% and 87.2%, respectively, and the difference was not statistically significant (P＞0.05 ). Conclusion Compared with TG, PG is more conducive to the absorption of nutrients and the recovery of nutritional status after surgery, and it is also important to take optimal reconstruction methods to reduce reflux in patients.  Adenocarcinoma of esophagogastric junction, Gastric tumor, Proximal gastrectomy, Total gastrectomy, Reflux Esophagitis, Lymph node dissection 201 205 2023/5/10 2024/2/20

Abstract

Objective To compare the advantages and disadvantages of two different resection margins by observing the clinical efficacy of laparoscopic total gastrectomy (TG) and proximal gastrectomy(PG) for radical resection of adenocarcinoma of esophagogastric junction (AEJ). Methods A total of 90 patients with AEJ who were treated by Huai ‘an No.1 People ‘s Hospital from January 2020 to December 2021 were retrospectively reviewed. Patients were divided into PG group ( n=43) and TG group ( n=47) according to the surgical resection range. The general data, surgery related statistical indicators of the two groups were compared. Results The TG group had a longer operation time than the PG group, with significantly more intraoperative blood loss and a greater number of intraoperatively cleared lymph nodes than the PG group (P＜0.05). There was no significant difference in terms of drainage volume of the abdominal drainage tubes in the 3day postoperative period, postoperative period to the drainage removal, the length of hospitalization, and postoperative complications between two groups (P>0.05). Postoperative levels of hemoglobin, albumin, and prealbumin were significant lower in TG group compared with those in PG group (P<0.05). The 1year overall survival rates for the PG group and TG group were 95.3% and 87.2%, respectively, and the difference was not statistically significant (P＞0.05 ). Conclusion Compared with TG, PG is more conducive to the absorption of nutrients and the recovery of nutritional status after surgery, and it is also important to take optimal reconstruction methods to reduce reflux in patients.

Keywords

• adenocarcinoma of esophagogastric junction
• gastric tumor
• proximal gastrectomy
• total gastrectomy
• reflux esophagitis
• lymph node dissection