Background: Conventional methods for treating patients with proximal gastric cancer (PGC) include proximal gastrectomy (PG) and total gastrectomy (TG) and such methods have become challenging due to double tract reconstruction (DTR). However, the clinical outcomes remain unclear. This study was performed with the aim of verifying that PG-DTR was beneficial in terms of reducing the incidence of postoperative complications and improving the prognosis.
Methods: The PGC patient cohort was retrospectively grouped into the PG-DTR and TG groups. Clinicopathological features, complications, and survival data were compared between the two groups.
Results: A total of 388 patients were included in the analyses. Patients who were subjected to TG tended to have more severe gastroesophageal reflux (GR) (P = 0.041), anemia (P = 0.007), and hypoalbuminemia (P < 0.001). Overall survival rates, regardless of clinical stage, were significantly different between the PG-DTR and TG groups (all P < 0.05). The multivariate Cox regression analysis confirmed that surgical procedure, tumor size, infiltration depth, lymph node metastasis, differentiation, and age were independent risk factors. The patients were likely to benefit from PG-DTR (all HR > 1 and P < 0.05). However, no significant differences were observed in the risks of GR, anemia, and hypoalbuminemia (all P > 0.05). Moreover, the nomogram derived from significant parameters showed great calibration and discrimination ability and significant clinical benefit.
Conclusions: The patients who underwent PG-DTR had a favorable prognosis. The risk of postoperative complications, such as severe GR, anemia, and hypoalbuminemia, was lower in PG-DTR than in TG. Thus, PG-DTR is more beneficial for patients with PGC and may be a valuable and promising surgical procedure.
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http://dx.doi.org/10.1186/s12957-023-02985-z | DOI Listing |
Int J Surg Case Rep
December 2024
Department of Public Health, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor 6300, Ethiopia.
Introduction And Importance: Intussusception in the proximal bowel is extremely rare, with only a few reported cases of gastroduodenal intussusception (GDI). Gastrogastric intussusception is the rarest form of intussusception in adults. Here, we present an exceptionally rare case of gastro-gastric intussusception caused by a gastric Gastrointestinal Stromal Tumor (GIST).
View Article and Find Full Text PDFLangenbecks Arch Surg
December 2024
Department of General Surgery, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, China.
Background: Laparoscopic total gastrectomy (LTG) is still limited because intracorporeal oesophagojejunostomy is technically demanding and difficult in laparoscopic gastrectomy. Circular-stapled anastomosis is considered the "gold standard" method for oesophagojejunostomy in open total gastrectomy. A purse-string suture instrument is used to create a purse-string suture along the distal oesophagus as a standard technique for classic circular-stapled oesophagojejunostomy in the open total gastrectomy.
View Article and Find Full Text PDFAsian J Endosc Surg
December 2024
Department of Surgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
Purpose: Double-tract reconstruction (DTR) is one of the major procedures following proximal gastrectomy (PG) with anti-reflex function for the esophagus. Although many studies demonstrated the feasibility of laparoscopic DTR, there is a lack of research on robotic DTR. We aimed to assess the safety and feasibility of robotic DTR following PG.
View Article and Find Full Text PDFJ Surg Case Rep
December 2024
Department of Surgery, Phramongkutklao Hospital, Thung Phaya Thai, Ratchathewi, Bangkok 10400, Thailand.
Endoscopic or fluoroscopic guided naso-enteric placement for stenting and decompression has been used in mechanical enteric limb obstruction after gastrectomy or gastric bypass surgery. However, the use of double naso-enteric tube for treatment of multiple enteric limbs obstruction has not been described to date. We present a 61-year-old female with afferent limb syndrome with concomitant efferent limb obstruction which caused by kinking of anastomosis after loop gastrojejunostomy for benign gastric outlet obstruction.
View Article and Find Full Text PDFInt J Surg Case Rep
November 2024
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. Electronic address:
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