Objective: To explore the optimal technique of digestive tract reconstruction for radical proximal gastrectomy.
Methods: The clinical data for 120 cases of proximal gastric cancer undergoing radical proximal gastrectomy at our hospital from 2000 to 2009 were analyzed retrospectively. They included three approaches of digestive tract reconstruction. The patients were divided into esophagogastric anterior wall anastomosis group (n = 50), jejunal interposition group (n = 26) and gastric tube group (n = 44). The quality of life was evaluated and compared among 3 groups.
Results: The rates of anastomotic fistula, anastomotic obstruction and the scores of heart burn and reflux esophagitis were higher in gastric tube group. And the increments of hemoglobin and body weight were less in gastric tube group than those in other groups (P < 0.05). The rates of gastric emptying in gastric tube group had no obvious differences with esophagogastric anterior wall anastomosis group at 120 min and 180 min (P > 0.05). And they were higher than those in jejunal interposition group (P < 0.05). There was no statistical difference in any parameter between esophagogastric anterior wall anastomosis and jejunal interposition groups (P > 0.05).
Conclusion: The anastomosis of esophagogastric anterior wall is an ideal approach of digestive reconstruction for radical proximal gastrectomy. And it may improve the quality of life for surgical patients with proximal gastric cancer.