Functional Advantages of Proximal Gastrectomy with Jejunal Interposition Over Total Gastrectomy with Roux-en-Y Esophagojejunostomy for Early Gastric Cancer

2015 ◽  
Vol 39 (11) ◽  
pp. 2726-2733 ◽  
Author(s):  
Masaki Ohashi ◽  
Shinji Morita ◽  
Takeo Fukagawa ◽  
Ichiro Oda ◽  
Ryoji Kushima ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Jejunal Interposition

scholarly journals Comparision between Proximal Gastrectomy and Total Gastrectomy in Early Gastric Cancer

2009 ◽  
Vol 54 (4) ◽  
pp. 212 ◽  
Author(s):  
Eun Mi Kim ◽  
Hyun Yong Jeong ◽  
Eom Seok Lee ◽  
Hee Seok Moon ◽  
Jae Kyu Sung ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy

scholarly journals A Case of Laparoscopic Resection for Carcinoma of the Gastric Remnant following Proximal Gastrectomy Reconstructed with Jejunal Interposition

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Kazuhito Yajima ◽  
Yoshiaki Iwasaki ◽  
Ken Yuu ◽  
Ryouki Oohinata ◽  
Misato Amaki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Early Stage ◽  
Proximal Gastrectomy ◽  
Laparoscopic Approach ◽  
Jejunal Interposition ◽  
Gastric Remnant ◽  
Successful Case ◽  
Old Japanese ◽  
Upper Third

A 72-year-old Japanese man had a history of proximal gastrectomy for early gastric cancer located in the upper third of the stomach in 2007. Our usual treatment strategy for early gastric cancer in the upper third of the stomach in 2007 was open proximal gastrectomy reconstructing by jejunal interposition with a 10 cm single loop. Upper gastrointestinal fiberscopy for annual follow-up revealed a type 0-IIc-shaped tumor with ulcer scar, 4.0 cm in size, located in the gastric remnant near the jejunogastrostomy. A clinical diagnosis of cancer of the gastric remnant, clinical T1b(SM)N0M0, Stage IA, following the proximal gastrectomy was made and a laparoscopic approach was selected because of the cancer’s early stage. Remnant total gastrectomy with D1 plus lymphadenectomy was carried out with five ports by a pneumoperitoneal method. Complete resection of the reconstructed jejunum was undergone along with the jejunal mesentery. Reconstruction by the Roux-en-Y method via the antecolic route was selected. Total operative time was 395 min and blood loss was 40 mL. Our patient was the first successful case of resection for carcinoma of the gastric remnant following proximal gastrectomy reconstructed with jejunal interposition in a laparoscopic approach.

The technique of laparoscopically assisted total gastrectomy with jejunal interposition for early gastric cancer

2001 ◽  
Vol 16 (3) ◽  
pp. 540-544 ◽  
Author(s):  
E. Mochiki ◽  
H. Kamimura ◽  
N. Haga ◽  
T. Asao ◽  
H. Kuwano
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Total Gastrectomy ◽  
Jejunal Interposition

scholarly journals Outcomes of laparoscopic proximal gastrectomy with jejunal interposition for proximal early gastric cancer

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Viet Trung Lam ◽  
Vo Vinh Loc Nguyen
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Proximal Gastrectomy ◽  
Case Series ◽  
Jejunal Interposition ◽  
Surgical Approaches ◽  
Safe Procedure ◽  
Female Ratio ◽  
Laparoscopic Proximal Gastrectomy

Abstract Introduction: Proximal gastrectomy is one of the modified surgical approaches for early gastric cancer located in the upper stomach instead of total gastrectomy. The preserving stomach helps for storage, digestion, and absorption of food and prevents anemia. Proximal gastrectomy with jejunal interinterposition has been reported to prevent and diminuate postoperative complications, such as reflux esophagitis and anastomotic stricture. Laparoscopic proximal gastrectomy (LPG) with jejunal interposition has been reported in the world with promising results. Aim of this study is to evaluate the feasibility and results of LPG with jejunal interposition for proximal early gastric cancer. Material and Methods: Descriptive prospective study ofconsecutive cases of laparoscopic proximal gastrectomy for early gastric cancer located in the upper stomach was conducted at Department of Digestive Surgery of Cho Ray hospital from 1/2015 to 6/2018, . Results: Of 8 cases of LPG for early gastric cancer located in the upper stomach was enrolled. Patients mean age was 55,5. Male/female ratio was 3/1. Tumor located at cardia in 7 cases and in fundus in 1 case. All the tumors were adenocarcinoma at cT1N0M0 stage. Mean operative time was 150 minutes. There was no intraoperative accident. Mean harvested lymph nodes were 5. There was no lymph node metastasis. No morbidity was noted. Mean postoperative hospital stay was 7 days. All patients tolerated well with food and have no regurgitation. With mean follow-up period of 28 months, there was no recurrence and mortality. Conclusion: Our initial case series demonstrated that LPG with jejunal interposition is a feasible, safe procedure and offering good functional and oncological outcomes. Futher follow-up time and more data should be needed to evaluate the effectiveness of this operation.

scholarly journals Clinical Outcomes of Proximal Gastrectomy versus Total Gastrectomy for Proximal Gastric Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-13
Author(s):  
Lulu Zhao ◽  
Rui Ling ◽  
Jinghua Chen ◽  
Anchen Shi ◽  
Changpeng Chai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Early Gastric Cancer ◽  
Total Gastrectomy ◽  
Meta Analysis ◽  
Proximal Gastrectomy ◽  
Perioperative Outcomes ◽  
Proximal Gastric Cancer ◽  
Term Survival

<b><i>Introduction:</i></b> The extent of optimal gastric resection for proximal gastric cancer (PGC) continues to remain controversial, and a final consensus is yet to be met. The current study aimed to compare the perioperative outcomes, postoperative complications, and overall survival (OS) of proximal gastrectomy (PG) versus total gastrectomy (TG) in the treatment of PGC through a meta-analysis. <b><i>Methods:</i></b> We systematically searched PubMed, Embase, The Cochrane Library, and Web of Science for articles published in English since database establishment to October 2019. Evaluated endpoints were perioperative outcomes, postoperative complications, and long-term survival outcomes. <b><i>Results:</i></b> A total of 2,896 patients in 25 full-text articles were included, of which one was a prospective randomized study, one was a clinical phase III trial, and the rest were retrospective comparative studies. The PG group showed a higher incidence of anastomotic stenosis (OR = 2.21 [95% CI: 1.08–4.50]; <i>p</i> = 0.03) and reflux symptoms (OR = 3.33 [95% CI: 1.85–5.99]; <i>p</i> &#x3c; 0.001) when compared with the TG group, while no difference was found in PG patients with double-tract reconstruction (DTR). The retrieved lymph nodes were clearly more in the TG group (WMD = −10.46 [95% CI: −12.76 to −8.17]; <i>p</i> &#x3c; 0.001). The PG group was associated with a better 5-year OS relative to TG with 11 included studies (OR = 1.35 [95% CI: 1.03–1.77]; <i>p</i> = 0.03). After stratification for early gastric cancer and PG with DTR groups, however, there was no significant difference between the 2 groups (OR = 1.35 [95% CI: 0.59–2.45]; <i>p</i> = 0.62). <b><i>Conclusion:</i></b> In conclusion, PG was associated with a visible improved long-term survival outcome for all irrespective of tumor stage, while a similar 5-year OS for only early gastric cancer patients between the 2 groups. Future randomized clinical trials of esophagojejunostomy techniques, such as DTR following PG, are expected to prevent postoperative complications and assist surgeons in the choice of surgical approach for PGC patients.

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