Clinical Comparison of Proximal Gastrectomy With Double-Tract Reconstruction Versus Total Gastrectomy With Roux-en-Y Anastomosis for Siewert Type II/III Adenocarcinoma of the Esophagogastric Junction.

IF 3.2 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Xiaoming Ma, Mingzuo Zhao, Jian Wang, Haixing Pan, Jianqiang Wu, Chungen Xing
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引用次数: 0

Abstract

Purpose: The incidence of adenocarcinoma of the esophagogastric junction (AEG) has increased in recent years, and the optimal surgical strategy for AEG remains highly controversial. We aimed to evaluate the safety and efficacy of proximal gastrectomy with double-tract reconstruction (PG-DT) for the treatment of patients with AEG.

Materials and methods: We retrospectively analyzed patients with Siewert type II/III AEG between January 2013 and July 2018. Clinicopathological characteristics, survival, surgical outcomes, quality of life (QOL), and nutritional status were compared between the PG-DT and total gastrectomy with Roux-en-Y anastomosis (TG-RY) groups.

Results: After propensity score matching, 33 patients in each group were analyzed. There were no statistical differences between the 2 groups in terms of disease-free survival and overall survival. The surgical option was not an independent prognostic factor based on the multivariate analysis. In addition, no differences were found in terms of surgical complications. There were no significant differences in QOL assessed by the Visick grade, Gastrointestinal Symptom Rating Scale, or endoscopic findings. Furthermore, the long-term nutritional advantage of the PG-DT group was significantly greater than that of the TG-RY group.

Conclusions: PG-DT is a safe and effective procedure for patients with local Siewert type II/III AEG, regardless of the TNM stage.

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食管胃交界siwert II/III型腺癌近端胃切除术双道重建与全胃切除术Roux-en-Y吻合术的临床比较
目的:近年来,食管胃交界处腺癌(AEG)的发病率有所增加,AEG的最佳手术策略仍存在很大争议。我们的目的是评估近端胃切除术联合双胃道重建(PG-DT)治疗AEG患者的安全性和有效性。材料和方法:我们回顾性分析2013年1月至2018年7月期间Siewert II/III型AEG患者。比较PG-DT组和全胃Roux-en-Y吻合术(TG-RY)组的临床病理特征、生存率、手术结果、生活质量(QOL)和营养状况。结果:经倾向评分匹配后,每组33例患者进行分析。两组患者的无病生存期和总生存期差异无统计学意义。基于多变量分析,手术选择不是一个独立的预后因素。此外,在手术并发症方面没有发现差异。通过Visick分级、胃肠道症状评定量表或内镜检查结果评估的生活质量没有显著差异。PG-DT组的长期营养优势显著大于TG-RY组。结论:无论TNM分期如何,PG-DT治疗局部siwert II/III型AEG是一种安全有效的治疗方法。
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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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