A Comparative Study on the Outcomes of Total and Proximal Gastrectomies Performed for Gastric Cancer

Lim, Hyo Jin; Jeong, Yeon Jun; Yang, Doo Hyun

Abstract

BACKGROUND/AIMS: The aim of this study was to analyze the clinicopathologic characteristics, nutritional status, and clinical outcomes of the patients who underwent total gastrectomy (TG) or proximal gastrectomy (PG).
METHODS
Seventy-three patients with gastric cancer who underwent TG (n=57) or PG (n=16) from January 1991 to December 2000, were divided into two groups (TG group and PG group). Then, their hospital records and survival data were retrospectively analyzed.
RESULTS
There was no significant difference in age, sex, tumor size, histologic type, time of gas out, hospital stay, postoperative mortality and morbidity, recurrence, and survival rates between the two groups. The PG group showed higher rates of the postoperative esophageal reflux and anastomotic stricture than the TG group (p<0.01). There was no significant difference in hemoglobin, body weight, and total protein between the two groups. However, serum cholesterol level was higher in the PG group than in the TG group 1 month and 12 months after operation (p<0.05).
CONCLUSIONS
The PG group showed higher rates of esophageal reflux and anastomotic stricture and hardly any nutritional advantages. Considering some previous reports asserting that PG combined with antireflux procedures prevents the esophageal reflux and increase the quality of life, further studies with a large number of patients are needed to confirm the advantages of the proximal gastrectomy in treating proximal gastric cancer.