Background: There is an upward shift in the incidence and localization of gastric cancer (GC). Proximal gastrectomy (PG) has been advocated as an alternative operation for upper-third GC. An uneventful postoperative course is currently measured using a well-defined textbook outcome (TO), which represents a composite of surgical quality metrics. The aim of this study was to compare TO after two reconstruction methods following PG: double-tract reconstruction (DTR) and posterior esophagogastrostomy with partial neo-fundoplication (EGF). Materials and Methods: Primary proximal gastric adenocarcinoma patients who had undergone PG with DTR or EGF were included in this study. In a prospectively collected database, DTR and EGF were identified in 30 and 30 patients, respectively. Results: Patients with DTR had a 5.5-fold higher chance of achieving TO compared to those with EGF (OR = 5.67;p= 0.0266). No statistically significant differences in overall survival were noted when both reconstruction methods were compared. Conclusion: In patients with proximal GC undergoing PG, TO is more likely to be achieved using DTR compared to EGF, with similar overall survival. Randomized controlled trials are warranted to indicate the preferred reconstruction technique after PG.
背景：胃癌（GC）的发病率和发生部位呈现上移趋势。近端胃切除术（PG）已被提倡作为上三分之一胃癌的替代手术方案。目前，术后平稳恢复过程通过明确定义的教科书结局（TO）进行衡量，该指标综合反映了手术质量。本研究旨在比较PG术后两种重建方法——双通道重建（DTR）与食管胃后壁吻合联合部分新胃底折叠术（EGF）的TO达成情况。材料与方法：本研究纳入接受PG联合DTR或EGF治疗的原发性近端胃腺癌患者。在前瞻性收集的数据库中，分别有30例患者接受DTR和EGF手术。结果：与接受EGF的患者相比，DTR组患者实现TO的几率高出5.5倍（OR=5.67；p=0.0266）。两种重建方法在总生存期方面无统计学显著差异。结论：在接受PG的近端胃癌患者中，与EGF相比，DTR更可能实现TO，且总生存期相似。有必要开展随机对照试验以明确PG术后的优选重建技术。
肿瘤(癌症)患者之家