Long-term quality-of-life comparison between three reconstruction methods after gastrectomy in patients with stage Ⅰ proximal gastric cancer / 中华普通外科杂志

ABSTRACT

Objective:To investigate the effects of three reconstruction methods after gastrectomy on long-term quality of life in patients with stage Ⅰ proximal gastric cancer.Methods:A retrospective study was performed on 157 cases including respectively total gastrectomy with Roux-en-Y anastomosis (TG+RY group, 75 cases), 39 cases of proximal gastrectomy with esophagogastrostomy (PG+EG group) and 43 cases of proximal gastrectomy with jejunal interposition anastomosis (PG+JI group). The primary outcomes were evaluated in terms of alimentary tract symptoms, nutritional status of postoperative patients and long-term complications. Secondary outcomes pertaining to safety and long-term survival status were included as well.Results:The improvement of Visick grading in PG+JI and TG+RY group were better than that in PG+EG group ( P adj<0.01); The nutritional status of PG+JI group was better than TG+RY group and PG+EG group ( P adj<0.01); PG+JI group and PG+EG group had extra complications related to remnant stomach, but there was no significant difference in anastomotic and biliary related complications among the three groups; The incidence of reflux esophagitis in PG+JI group was significantly lower than that in PG+EG group ( P adj<0.01). There was no significant difference between the three groups in operation time, intraoperative blood loss, early postoperative complications, pathological results, 5-year cumulative survival rate and 5-year disease-free survival rate ( P>0.05). Conclusions:PG+JI improves the long-term quality of life for patients with stage Ⅰ proximal gastric cancer compared to TG+RY and PG+EG .