Proximal Gastrectomy with Double Tract Reconstruction Using the Remnant Antrum in Early Upper Gastric Cancer

Jung, Hyuk Jae; Kim, Dae Hwan; Kim, Dong Heon

Abstract

PURPOSE: The purpose of this study is to evaluate the safety and feasibility of a proximal gastrectomy with a double tract reconstruction using remnant antrum in patients with early upper gastric cancer.
METHODS
Between July 2003 and June 2005, we analyzed 45 patients with early upper gastric cancer, with 19 patients receiving a proximal gastrectomy with double tract reconstruction using the remnant antrum (Group A) and 26 receiving a total gastrectomy with a Roux-en Y anastomosis(Group B). We retrospectively analyzed the clinical characteristics (age, sex, operation time, duration of postoperative hospital stay, duration of follow-up), pathologic characteristics, postoperative nutritional status, complications, and recurrence rates between the two groups.
RESULTS
There were no significant differences in the clinical characteristics of the two groups. However, the operation time of group A was significantly longer than group B. The total protein and albumin levels at 3 months, the serum iron and calcium levels by 6 months, and BMI at 3 and 6 months were significantly higher in group A than group B. There were no significant differences of postoperative complications between the two groups. However, the rate and degree of reflux esophagitis in group A were significantly lower than group B.
CONCLUSION
Proximal gastrectomy with double tract reconstruction using the remnant antrum is a safe, feasible, function-preserving surgery for early upper gastric cancer.