Comparison on the Efficacy of Double Tract Gastric Interposition Reconstruction Versus Jejunal Interposition Reconstruction After Proximal Gastrectomy

Abstract Objective Proximal gastrectomy acts as a function-preserving operation for upper-third gastric cancer. The aim of this study was to compare the short-term surgical outcomes between proximal gastrectomy with gastric tube reconstruction and proximal gastrectomy with jejunal interposition reconstruction in upper-third gastric cancer. Methods A retrospective review of 301 patients who underwent proximal gastrectomy with jejunal interposition (JI) or gastric tube (GT) at Harbin Medical University Cancer Hospital between June 2007 and December 2016 was performed. The Gastrointestinal Symptom Rating Scale (GSRS) and Visick grade were used to evaluate postgastrectomy syndromes. Gastrointestinal fiberoscopy was used to evaluate the prevalence and severity of reflux esophagitis based on the Los Angeles (LA) classification system. Results The JI group had a longer operation time than the GT group (220 ± 52 vs 182 ± 50 min), but no significant difference in blood loss was noted. Compared to the GT group, the Visick grade and GSRS score were significantly higher. Reflux esophagitis was significantly increased in the GT group compared with the JI group. Conclusion Proximal gastrectomy is well tolerated with excellent short-term outcomes in patients with upper-third gastric cancer. Compared with GT construction, JI construction has clear functional advantages and may provide better quality of life for patients with upper-third gastric cancer.

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Proximal Gastrectomy with Gastric Tube Reconstruction or Jejunal Interposition Reconstruction in the Upper Third Gastric Cancer: Which is Better for the Surgical Short-Term Outcomes.

10.21203/rs.3.rs-194845/v1 ◽

2021 ◽

Author(s):

Zhiguo Li ◽

Yan Ma ◽

Guiting Liu ◽

Ming Fang ◽

YingWei Xue

Keyword(s):

Gastric Cancer ◽

Reflux Esophagitis ◽

Gastric Tube ◽

Proximal Gastrectomy ◽

Jejunal Interposition ◽

Short Term ◽

Significant Difference ◽

Jejunal Interposition Reconstruction ◽

Upper Third ◽

Gastric Tube Reconstruction

Abstract Objective: Proximal gastrectomy was acted as a function-preserving operation for upper third gastric cancer. The aim of this study is to compare the surgical short-term outcomes between proximal gastrectomy with gastric tube reconstruction and proximal gastrectomy with Jejunal interposition reconstruction in the upper third gastric cancer. Methods: A retrospective review of 301 patients who underwent proximal gastrectomy with jejunal interposition (JI) or gastric tube (GT) at the Harbin Medical University Cancer Hospital between June 2007 and December 2016 was performed. The Gastrointestinal Symptom Rating Scale (GSRS) and Visick grade were used to evaluate the post-gastrectomy syndromes. The gastrointestinal fiberoscopy was used to evaluate the prevalence and severity of reflux esophagitis by Los Angeles (LA) classification system. Results: The JI group had a longer operation time than GT group (220±52 vs 182±50 min), whereas there was no significant difference in blood loss. Compared to the GT group, the Visick grade and GSRS score were significantly higher than that of the JI group. The reflux esophagitis of GT group was significantly higher than that of the JI group. Conclusion: Proximal gastrectomy is well tolerated, with excellent short-outcomes in patients with upper third gastric cancer . C ompared with GT construction, JI construction has clear functional advantages and may provide better quality of life for patients with upper third gastric cancer.

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A Pilot Study Comparing Jejunal Pouch and Jejunal Interposition Reconstruction after Proximal Gastrectomy

Digestive Surgery ◽

10.1159/000321224 ◽

2010 ◽

Vol 27 (6) ◽

pp. 502-508 ◽

Cited By ~ 18

Author(s):

Ryo Takagawa ◽

Chikara Kunisaki ◽

Jun Kimura ◽

Hirochika Makino ◽

Takashi Kosaka ◽

...

Keyword(s):

Pilot Study ◽

Proximal Gastrectomy ◽

Jejunal Interposition ◽

Jejunal Pouch ◽

Jejunal Interposition Reconstruction

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A Novel Method of Piggyback Jejunal Interposition Reconstruction Single-Tract Reconstruction After Proximal Gastrectomy for Siewert II and III Adenocarcinoma of the Esophagogastric Junction with a Diameter <4 cm

10.21203/rs.3.rs-1131676/v1 ◽

2021 ◽

Author(s):

Yuchao Ma ◽

Jianhong Dong ◽

Baoqing Ren ◽

Wanhong Zhang ◽

Liqiang Lei ◽

...

Keyword(s):

Reflux Esophagitis ◽

Complication Rate ◽

Esophagogastric Junction ◽

Proximal Gastrectomy ◽

Jejunal Interposition ◽

Reflux Symptoms ◽

Postoperative Reflux ◽

Novel Method ◽

The Mean ◽

Jejunal Interposition Reconstruction

Abstract Background Digestive tract reconstruction after proximal gastrectomy (PG) has been extensively discussed. Herein, we introduce a novel method of PG with piggyback jejunal interposition reconstruction single-tract reconstruction (PJIRSTR) for Siewert II and III adenocarcinoma of the esophagogastric junction (AEG) with a diameter <4 cm, and investigate its safety, practicability, and short-term and long-term clinical outcomes of this procedure. Method The clinical data of 33 patients with Siewert II or Siewert III AEG who underwent PJIRSTR in Shanxi Cancer Hospital from July 2013 to November 2016 were retrospectively reviewed. Data of clinicopathologic characteristics, postoperative and surgical outcomes, and follow-up findings, especially postoperative reflux esophagitis and postoperative reflux symptoms, were analyzed.Results The mean operation time was 136.7±22.4 (range: 110-180) min, including 32.3 ± 5.0(range: 26-45) min of the digestive tract reconstruction; the mean estimated blood loss was 87.6±18.1 mL; the mean number of dissected lymph nodes was 14.7±5.1; and the mean duration of postoperative hospitalization was 7.5±1.2 days. The early complication rate was 9% (n=3), including one case each of anastomotic bleeding, incision infection, and ileus. The late complication rate was 6% (n=2): both patients had gastroesophageal reflux symptoms (Visick grade II), but only one patient had Los Angeles grade B reflux esophagitis by endoscopy. Conclusion PJIRSTR is a safe, feasible, and innovative reconstruction method after PG for patients with Siewert II and III AEG with a diameter <4 cm. Furthermore, it has excellent efficiency in terms of preventing reflux symptoms and reflux esophagitis after surgery.

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Endoscopic evaluation of reconstruction after proximal gastrectomy for cancer: Gastric tube versus jejunal interposition

Digestive Endoscopy ◽

10.1046/j.1443-1661.2001.d01-5.x ◽

2001 ◽

Vol 10 (4) ◽

pp. 191-194

Author(s):

Kenji Kakisako ◽

Yoichi Tamura ◽

Takeshi Katsuta ◽

Tetsuji Kai ◽

Hideyuki Tanimura ◽

...

Keyword(s):

Gastric Tube ◽

Proximal Gastrectomy ◽

Jejunal Interposition ◽

Endoscopic Evaluation ◽

Tube Versus

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Laparoscopic Proximal Gastrectomy with Jejunal Interposition for Early Proximal Gastric Cancer

Journal of Gastrointestinal Cancer ◽

10.1007/s12029-020-00420-0 ◽

2020 ◽

Author(s):

Lam Viet Trung ◽

Nguyen Vo Vinh Loc ◽

Tran Phung Dung Tien ◽

Nguyen Lam Vuong

Keyword(s):

Gastric Cancer ◽

Proximal Gastrectomy ◽

Jejunal Interposition ◽

Proximal Gastric Cancer ◽

Laparoscopic Proximal Gastrectomy

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Reconstruction Methods and Complications of Esophagogastrostomy and Jejunal Interposition in Proximal Gastrectomy for Gastric Cancer: A Meta-Analysis

Gastroenterology Research and Practice ◽

10.1155/2020/8179254 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Nan Du ◽

Pei Wu ◽

Pengliang Wang ◽

Yuwei Du ◽

Kai Li ◽

...

Keyword(s):

Gastric Cancer ◽

Lower Risk ◽

Meta Analysis ◽

Proximal Gastrectomy ◽

Operating Time ◽

Perioperative Period ◽

Jejunal Interposition ◽

Cochrane Library ◽

Reconstruction Methods ◽

Significant Difference

Background. Proximal gastrectomy is used for the treatment of primary gastric cancer by open or laparoscopic surgery in the upper third of the stomach. Esophagogastrostomy (EG) or jejunal interposition (JI) is widely used in various reconstruction methods after proximal gastrectomy. We conducted a meta-analysis of EG and JI for treatment of gastric cancer. Materials and Methods. A search of PubMed, Embase, MEDLINE, J-STAGE, and Cochrane Library identified retrospective series on EG and JI. Weight mean differences (WMDs), odds ratios (ORs), and 95% confidence intervals (CIs) were used to analyze the operation-related data and postoperative complications. Heterogeneity was evaluated by the I2 test, and potential publication bias was assessed with Egger regression tests and sensitivity analysis. Results. Eight studies were selected, and 496 patients were included. EG group benefits were 44.81 min shorter operating time (P<0.001), 56.58 mL less blood loss (P=0.03), and 7.4 days shorter hospital stay time (P<0.001) than the JI group. Between the two groups, there was no significant difference in anastomotic leakage; otherwise, the EG group had a lower risk of anastomotic stenosis (OR=0.44, 95%CI=0.20 to 0.97, P=0.04), lower risk of intestinal obstruction (OR=0.07, 95%CI=0.01 to 0.43, P=0.004), and higher risk of reflux esophagitis (OR=2.47, 95%CI=1.07 to 5.72, P=0.03). Conclusion. The results of our study indicated that EG has significant advantages during the perioperative period and in short-term outcomes compared to JI.

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