Long-term outcome after proximal gastrectomy with jejunal interposition for suspected early cancer in the upper third of the stomach

Abstract

Background: Proximal gastrectomy was introduced as a function-preserving operation for early gastric cancer (EGC). The aim of this study was to investigate long-term outcomes after this procedure. Methods: Between 1993 and 2005, patients with suspected EGC in the upper third of the stomach underwent proximal gastrectomy. The long-term oncological and surgical outcomes were assessed. Results: Of 128 patients thought to have EGC, 14 had advanced disease. Nodal involvement was seen in 13 patients (10-2 per cent). Postoperative complications developed in 20 (15-6 per cent). Anastomotic stricture was the most frequent complication, occurring in 13 patients (10-2 per cent). There were no postoperative deaths. During follow-up, nine patients (7-0 per cent) were hospitalized owing to bowel obstruction. Eight (6-3 per cent) developed a second primary gastric carcinoma. The overall 5-year survival rate was 90-5 per cent. Conclusion: Proximal gastrectomy is well tolerated, with excellent outcomes in patients with suspected EGC. It is recommended as a standard procedure for the treatment of EGC in the upper third of the stomach. Copyright © 2010 British Journal of Surgery Society Ltd.