Comparative Studies between Esophagogastrostomy and Jejunal Interposition after Proximal Gastrectomy for Cardiac Cancer of the Stomach

Kazuhiro Seike, Taira Kinoshita, Masanori Sugito, Tatsuo Arai, Masato Ono, Shinji Taniyama, Yoshinori Shirai, Noriaki Kawano, Masaru Konishi, Munemasa Ryu

Department of Surgery, National Cancer Center Hospital East

Reconstruction after proximal gastrectomy is still controversial. To compare the results of the two different reconstruction methods, 24 patients with relatively erly staged gastric cancer who underwent proximal gastrectomy were analyzed retrospectively. Ten patients received esophagogastrostomy (EG group) and 14 received single jejunal interposition (JI group). The mean operation time of the EG group was significantly shorter than that of the JI group. There was no significant difference in the bleeding volume and postoperative stay, but the EG group showed less blood loss and shorter hospital stay. Regarding anastomotic stenosis, one patient in the EG group had a symptom of dysphagia and 11 patients in the JI group had that. Eight of the 11 patients in the JI group received endoscopic dilatation of the anastomotic stenosis. However only one of the 10 patients in the EG group received such procedure. Concering reflux esophagitis, there were three patients in the EG group which have hearburn but seven in the JI group. Endoscopic findings of reflux esophagitis were present in four patients in the EG group, and none in the JI group. The nutritional status and the body weight change showed no difference between the two group. The fact that the JI group only showed the better result of endoscopic findings of reflux esophatitis but showed no better results concering postoperative symptoms than that of EG group, leads the conclusion of the necessity to improve the method of jejunal interposition after proximal gastrectomy.

Key words
proximal gastrectomy, esophagogastrostomy, jejunal interposition

Reprint requests
Kazuhiro Seike First Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Chuoku, Chiba, 260-8677 JAPAN

Accepted
January 14, 1998

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