Journal List > J Korean Gastric Cancer Assoc > v.2(3) > 1036873

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Noh, Jeong, Lee, Cho, Shin, Song, and Lee: Pylorus-preserving Proximal Gastrectomy vs. Total Gastrectomy with Jejunal Interposition for Proximal Gastric Adenocarcinomas
Original Article

Journal of the Korean Gastric Cancer Association 2002; 2(3): 145-150.

Published online: 14 March 2017

DOI: https://doi.org/10.5230/jkgca.2002.2.3.145

Pylorus-preserving Proximal Gastrectomy vs. Total Gastrectomy with Jejunal Interposition for Proximal Gastric Adenocarcinomas

Seung Moo Noh, M.D.1, 6, Hyun Yong Jeong, M.D.2, Byong Seok Lee, M.D.2, June Sik Cho, M.D.3, Kyung Sook Shin, M.D.3, Kyu Sang Song, M.D.4, Tae yong Lee, M.D.5

1Department of Surgery, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.

2Department of Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.

3Department of Diagnostic Radiology, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.

4Department of Pathology, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.

5Department of Preventive & Public Health, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.

6Chungnam National University Cancer Research Institute, Daejeon, Korea.

Corresponding author (seungnoh@cnu.ac.kr)

Copyrights © 2002 by The Korean Gastric Cancer Association

Abstract

Purpose

The aim of this study was to evaluate the shortterm outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma.

Materials and Methods

For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition.

Results

The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05).

Conclusion

We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pyloruspreserving proximal gastrectomy is a common problem to be solved in the future.

Keywords: Pylorus-preserving proximal gastrectomy, Total gastrectomy, Jejunal interposition

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