Can proximal gastrectomy be an alternative to total gastrectomy due to its nutritional advantage? A retrospective cohort study.

IF 1.6 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2025-02-01 Epub Date: 2025-01-24 DOI:10.4174/astr.2025.108.2.79

Ogün Aydoğan, Muhammed Çağrı Coşkun, Ulaş Utku Şekerci, Erdem Barış Cartı

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引用次数: 0

Abstract

Purpose: This study aims to evaluate the outcomes of proximal gastrectomy (PG) compared to total gastrectomy (TG) in patients with proximal stomach cancer, focusing on nutritional advantages and overall survival.

Methods: A retrospective review was conducted on 87 patients who underwent gastrectomy for stomach cancer at Adnan Menderes University from January 2016 to January 2023. Among them, 21 patients underwent PG and 32 patients underwent TG. Clinical parameters, nutritional status, postoperative gastrointestinal symptoms, and survival rates were compared between the 2 groups. Statistical analyses included the chi-square test, Student t-test, and Mann-Whitney U-test.

Results: The PG group showed significantly less weight loss at 12 months (6.9 ± 5.2 kg vs. 17.9 ± 4.0 kg, P < 0.001) and higher albumin levels at both 6 and 12 months, postoperatively (P < 0.001). The reflux index was higher in the PG group (9.4 ± 2.4 vs. 5.2 ± 1.6, P < 0.001), but there was no significant difference in overall Gastrointestinal Symptom Rating Scale scores (P = 0.266). Disease-specific and overall survival were significantly better in the PG group (P = 0.004 and P = 0.003, respectively).

Conclusion: PG offers significant nutritional advantages and improved survival outcomes compared to TG despite higher rates of reflux. These findings suggest that PG can be a viable, function-preserving alternative to TG for patients with proximal stomach cancer. Further large-scale, prospective studies are needed to confirm these results and ensure oncological safety.

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近端胃切除术是否可以替代全胃切除术，因为其营养优势？回顾性队列研究。

目的：本研究旨在评估近端胃癌患者行近端胃切除术（PG）与全胃切除术（TG）的预后，重点关注营养优势和总生存期。方法：回顾性分析2016年1月至2023年1月Adnan Menderes大学87例胃癌切除术患者的资料。其中PG 21例，TG 32例。比较两组患者的临床参数、营养状况、术后胃肠道症状及生存率。统计分析包括卡方检验、学生t检验和Mann-Whitney u检验。结果：PG组术后12个月体重减轻（6.9±5.2 kg vs. 17.9±4.0 kg, P < 0.001），术后6个月和12个月白蛋白水平均升高（P < 0.001）。PG组反流指数较高（9.4±2.4比5.2±1.6,P < 0.001），但胃肠道症状评定量表总分无显著差异（P = 0.266）。PG组的疾病特异性和总生存率显著高于对照组（P = 0.004和P = 0.003）。结论：尽管反流率较高，但与TG相比，PG具有显著的营养优势和改善的生存结果。这些发现表明PG可以作为近端胃癌患者的一种可行的、保留功能的替代TG。需要进一步的大规模前瞻性研究来证实这些结果并确保肿瘤安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).