scholarly journals Clinical outcomes of proximal gastrectomy for gastric cancer: A comparison between the double-flap technique and jejunal interposition

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247636
Author(s):  
Tsutomu Kumamoto ◽  
Mitsuru Sasako ◽  
Yoshinori Ishida ◽  
Yasunori Kurahashi ◽  
Hisashi Shinohara
Keyword(s):  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Nutritional Status ◽  
Clinical Outcomes ◽  
Surgical Outcomes ◽  
Proximal Gastrectomy ◽  
Body Weight Loss ◽  
Jejunal Interposition ◽  
Flap Technique

Background The optimal reconstruction method after proximal gastrectomy (PG) has been debatable. Recent reports have shown that the double-flap technique (DFT) provides good outcomes in terms of postoperative nutritional status and quality of life. However, no study has compared the clinical outcomes of the DFT with other reconstruction methods. Here, we evaluated and compared the clinical outcomes between the DFT and jejunal interposition (JI) after PG for gastric cancer. Materials and methods The medical records of 34 consecutive patients who had undergone PG for upper third gastric cancer between January 2011 and October 2016 were reviewed retrospectively. The main factors investigated were surgical outcomes, postoperative nutritional status, symptoms, and endoscopic findings 1 year after surgery. Results Thirty-four patients were enrolled (DFT, 14; JI, 20). The operation time was similar between the two techniques (228 and 246 minutes for DFT and JI, respectively, P = 0.377), as were the rates of anastomotic complications (7% and 0% for DFT and JI, respectively, P = 0.412). Body weight loss was significantly lower in the DFT group than in the JI group (-8.1% vs -16.1%, P = 0.001). Total protein and albumin levels were higher in the DFT group than in the JI group (0% vs -2.9%, P = 0.053, and -0.3% vs -6.1%, P = 0.077, respectively). One patient in the DFT group and no patients in the JI group experienced reflux esophagitis (≥ grade B) (P = 0.393). Anastomotic strictures were not observed as postoperative complications in either group. Conclusions Surgical outcomes revealed that the DFT was safe and feasible, similar to JI. In terms of controlling postoperative body weight loss, the DFT is a better reconstruction technique than JI after PG.

Tu1309 Impact of Laparoscopic Proximal Gastrectomy for Early Upper Gastric Cancer on Body Weight Loss and Quality of Life

2016 ◽  
Vol 150 (4) ◽  
pp. S871
Author(s):  
Tatsuto Nishigori ◽  
Hiroshi Okabe ◽  
Hisashi Shinohara ◽  
Shigeru Tsunoda ◽  
Hisahiro Hosogi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Proximal Gastrectomy ◽  
Body Weight Loss ◽  
Laparoscopic Proximal Gastrectomy ◽  
Early Upper

scholarly journals Double Flap Technique is an Effective Reconstruction Procedure After Proximal Gastrectomy for Gastric Cancer

2021 ◽  
Author(s):  
Zenichiro Saze ◽  
Koji Kase ◽  
Hiroshi Nakano ◽  
Naoto Yamauchi ◽  
Akinao Kaneta ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Body Weight ◽  
Nutritional Status ◽  
Reflux Esophagitis ◽  
Proximal Gastrectomy ◽  
Case Series ◽  
Gastric Remnant ◽  
Weight Changes ◽  
Reconstructive Procedures ◽  
Flap Technique

Abstract Background In accordance with an increase of proximal gastric cancer, proximal gastrectomy came to be widely performed. Several types of reconstructive procedures after proximal gastrectomy have been developed and it is still controversial which procedure has the advantages in preservation of postoperative gastric stump function and nutritional status after proximal gastrectomy. In this study, we retrospectively analyzed reconstructive procedures in our consecutive case series for proximal gastrectomy, with particular focus on postoperative body weight maintenance, nutritional status, and gastric remnant functional preservation. Methods We enrolled 69 patients who received proximal gastrectomy for gastric cancer in our institute from 2005 to 2020. Short-term complications, preservation of gastric remnant functions, nutritional status, and post-operative weight changes were compared. Results After proximal gastrectomy, the numbers of cases receiving Direct Esophago-Gastrostomy, Jejunal Interposition, Double Tract Reconstruction, and Double Flap Technique were 9, 10, 14, and 36, respectively. Double Flap Technique cases suffered no reflux esophagitis after surgery. Prevalence of gastric residual at 12-month after surgery of Double Flap Technique was the lowest. Double Flap Technique group has better tendency in post-operative changes of serum albumin ratios. Furthermore, post-operative body weight changes ratio of Double Flap Technique was the smallest and significantly better than Double Tract at all the time points. Conclusions Double Flap Technique after proximal gastrectomy was considered as the most effective reconstruction which can maintain body weight, cause less reflux esophagitis and gastric residual.

scholarly journals Proximal gastrectomy with gastric tube reconstruction or jejunal interposition reconstruction in upper-third gastric cancer: which offers better short-term surgical outcomes?

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhiguo Li ◽  
Yan Ma ◽  
Guiting Liu ◽  
Ming Fang ◽  
Yingwei Xue
Keyword(s):  
Gastric Cancer ◽  
Reflux Esophagitis ◽  
Surgical Outcomes ◽  
Gastric Tube ◽  
Proximal Gastrectomy ◽  
Jejunal Interposition ◽  
Short Term ◽  
Jejunal Interposition Reconstruction ◽  
Upper Third ◽  
Gastric Tube Reconstruction

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.

Postoperative body-weight loss and survival after curative resection for gastric cancer

2002 ◽  
Vol 89 (4) ◽  
pp. 467-470 ◽  
Author(s):  
W. Yu ◽  
B. Y. Seo ◽  
H. Y. Chung
Keyword(s):  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Curative Resection ◽  
Body Weight Loss

Superiority of laparoscopic proximal gastrectomy with hand-sewn esophagogastrostomy over total gastrectomy in improving postoperative body weight loss and quality of life

2017 ◽  
Vol 31 (9) ◽  
pp. 3664-3672 ◽  
Author(s):  
Tatsuto Nishigori ◽  
Hiroshi Okabe ◽  
Shigeru Tsunoda ◽  
Hisashi Shinohara ◽  
Kazutaka Obama ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Body Weight ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Body Weight Loss ◽  
Laparoscopic Proximal Gastrectomy

scholarly journals Short-term and long-term comparisons of laparoscopy-assisted proximal gastrectomy with esophagogastrostomy by the double-flap technique and laparoscopy-assisted total gastrectomy for proximal gastric cancer

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242223
Author(s):  
Tomoko Tsumura ◽  
Shinji Kuroda ◽  
Masahiko Nishizaki ◽  
Satoru Kikuchi ◽  
Yoshihiko Kakiuchi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Nutritional Status ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Proximal Gastric Cancer ◽  
Short Term ◽  
Flap Technique ◽  
Significant Difference

Background Although proximal gastrectomy (PG) is a recognized surgical procedure for early proximal gastric cancer, total gastrectomy (TG) is sometimes selected due to concern about severe gastroesophageal reflux. Esophagogastrostomy by the double-flap technique (DFT) is an anti-reflux reconstruction after PG, and its short-term effectiveness has been reported. However, little is known about the long-term effects on nutritional status and quality of life (QOL). Methods Gastric cancer patients who underwent laparoscopy-assisted PG (LAPG) with DFT or laparoscopy-assisted TG (LATG) between April 2011 and March 2014 were retrospectively analyzed. Body weight (BW), body mass index (BMI), and prognostic nutritional index (PNI) were reviewed to assess nutritional status, and the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 was used to assess QOL. Results A total of 36 patients (LATG: 17, LAPG: 19) were enrolled. Four of 17 LATG patients (24%) were diagnosed with Stage ≥II after surgery, and half received S-1 adjuvant chemotherapy. BW and PNI were better maintained in LAPG than in LATG patients until 1-year follow-up. Seven of 16 LATG patients (44%) were categorized as “underweight (BMI<18.5 kg/m2)” at 1-year follow-up, compared to three of 18 LAPG patients (17%; p = 0.0836). The PGSAS-45 showed no significant difference in all QOL categories except for decreased BW (p = 0.0132). Multivariate analysis showed that LATG was the only potential risk factor for severe BW loss (odds ratio: 3.03, p = 0.0722). Conclusions LAPG with DFT was superior to LATG in postoperative nutritional maintenance, and can be the first option for early proximal gastric cancer.

1122 A phase III trial to confirm preventing effects of perioperative enteral EPA-enriched immunonutrition on body weight loss after total gastrectomy for gastric cancer

2015 ◽  
Vol 51 ◽  
pp. S171
Author(s):  
N. Hiki ◽  
T. Yoshikawa ◽  
K. Sakamaki ◽  
S. Ito ◽  
K. Fujitani ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Total Gastrectomy ◽  
Body Weight Loss ◽  
Phase Iii ◽  
Phase Iii Trial

scholarly journals Surgical outcomes and risk assessment for anastomotic complications after laparoscopic proximal gastrectomy with double-flap technique for upper-third gastric cancer

2019 ◽  
Vol 22 (5) ◽  
pp. 1036-1043 ◽  
Author(s):  
Yoshiaki Shoji ◽  
Souya Nunobe ◽  
Satoshi Ida ◽  
Koshi Kumagai ◽  
Manabu Ohashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Risk Assessment ◽  
Surgical Outcomes ◽  
Proximal Gastrectomy ◽  
Anastomotic Complications ◽  
Flap Technique ◽  
Laparoscopic Proximal Gastrectomy ◽  
Upper Third

scholarly journals Long‐term effects of an oral elemental nutritional supplement on post‐gastrectomy body weight loss in gastric cancer patients (KSES002)

2019 ◽  
Vol 3 (6) ◽  
pp. 648-656 ◽  
Author(s):  
Yutaka Kimura ◽  
Kazuhiro Nishikawa ◽  
Kentaro Kishi ◽  
Kentaro Inoue ◽  
Jin Matsuyama ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Cancer Patients ◽  
Body Weight Loss ◽  
Nutritional Supplement ◽  
Long Term Effects ◽  
Gastric Cancer Patients
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