COMPARATIVE STUDIES BETWEEN ESOPHAGOGASTROSTOMY AND JEJUNAL POUCH INTERPOSITION AFTER PROXIMAL GASTRECTOMY FOR EARLY GASTRIC CANCER

Abstract

T he postoperative condition of patients w ith early gastric cancer w ho underw ent proxim al gas- trectomyreconstructedbyjejunalpouchinterposition(JPIgroup,n=14)wasanalizedretrospectivelyin comparisonwithreconstructionbyesophagogastrostomy(EGgroup,n=2)duringthesameperiod,from 1996to2006.TheoperativetimeoftheEGgroup(131min)wassignificantlyshorterthanthatoftheJPI group(161min).Nosignificantdiferencewassenbetwenthetwogroupsinbloodlosandpostoper- ativestay. Therewasnosignificantdiferenceinpostoperativecomplicationsincludinganastomotic leakage,stenosis,pancreatitis,intestinalobstruction,andpneumonia.Nosignificantdiferencewasseen inclinicalsymptomsofheartburn,gastricfulnes,vomiting,diarhea,andDumpingsyndrome.There w as also no significant dif ference in food intake, nutrition status, and body w eight los s change. Endoscopicexaminationoneyearaftertheoperationshowednosignificantdiferencesincludingreflux esophagitis,anastomoticstenosis,remnantgastritis,andbileregurgitation.A highincidenceoffood residueintheremnantstomachorjejunalpouchwasfoundinJPIgroup(80.0%),asignificantlyhigher proportionthanthatfoundinEG group(14.3%).JPIgroupshowednobeterresultsforpostoperative symptomsthanEG group.Intermsofoperationtimeandfoodresidue,EG groupwassuperiortoJPI group.A simpleandconventionalreconstructiveprocedurebyesophagogastrostomyshouldbeindicated afterproximalgastrectomy.