Comparison of operative outcomes between proximal and total gastrectomy for proximal gastric cancer.

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Journal of the Chinese Medical Association : JCMA Pub Date : 2025-10-01 Epub Date: 2025-09-03 DOI:10.1097/JCMA.0000000000001287

Chin-Yung Chen, Ching-Yun Kung, Bor-Shiuan Shyr, Kuo-Hung Huang, Wen-Liang Fang, Shih-Chieh Lin, Anna Fen-Yau Li, Su-Shun Lo, Chew-Wun Wu, Yuan-Tzu Lan

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Abstract

Background: Total gastrectomy and proximal gastrectomy (PG) are both treatment options for proximal gastric cancer. Currently, there is no consensus on which procedure is better. The aim of this study was to compare the operative outcomes between PG and total gastrectomy in the treatment of proximal gastric cancer.

Methods: Between January 2000 and October 2022, patients who underwent either PG with double tract reconstruction (PG-DTR) or total gastrectomy with Roux-en-Y reconstruction (TG-RY) for proximal gastric cancer were included. The clinicopathologic characteristics and operative outcomes were compared between the two groups. Propensity score matching was performed to compare the short- and long-term outcomes between the two groups.

Results: A total of 263 patients were included in the study. After propensity-score matching, there was no significant difference in clinicopathological characteristics between the two groups. The TG-RY group had more retrieved lymph nodes (37.8 ± 18.6 vs 28.7 ± 15.4; p = 0.022) and a longer hospital stay (13.6 ± 10.2 vs 9.4 ± 3.3 days; p = 0.036) than the PG-DTR group. Surgical complications were similar between the two groups. The PG-DTR group had a greater prevalence of reflux esophagitis (21.4% vs 7.1%; p = 0.034), a higher postoperative/preoperative body weight ratio (0.91 ± 0.08 vs 0.84 ± 0.14; p = 0.021), and a higher postoperative/preoperative serum albumin ratio (1.07 ± 0.11 vs 0.96 ± 0.18; p = 0.004) than the TG-RY group.

Conclusion: Compared with TG-RY, PG-DTR was associated with better postoperative nutritional status and comparable operative complications.

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近端胃癌近端切除术与全胃切除术手术效果比较。

背景：全胃切除术和近端胃切除术（PG）都是近端胃癌的治疗选择。目前，对于哪种程序更好还没有达成共识。本研究的目的是比较近端胃切除术和全胃切除术治疗近端胃癌的手术效果。方法：纳入2000年1月至2022年10月期间，因近端胃癌行近端胃切除术联合双道重建术（PG-DTR）或全胃切除术联合Roux-en-Y重建术（TG-RY）的患者。比较两组患者的临床病理特征及手术结果。进行倾向评分匹配来比较两组之间的短期和长期结果。结果：共纳入263例患者。经倾向评分匹配后，两组患者的临床病理特征无显著差异。TG-RY组比PG-DTR组有更多的淋巴结（37.8±18.6比28.7±15.4,p=0.022）和更长的住院时间（13.6±10.2比9.4±3.3天，p=0.036）。两组手术并发症相似。PG-DTR组反流性食管炎患病率较高（21.4%比7.1%,p=0.034），术后/术前体重比（0.91±0.08比0.84±0.14,p=0.021），术后/术前血清白蛋白比（1.07±0.11比0.96±0.18,p=0.004）高于TG-RY组。结论：与TG-RY相比，PG-DTR术后营养状况较好，手术并发症较少。

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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Journal of the Chinese Medical Association : JCMA

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