The comparison of two reconstruction methods of alimentary canal for proximal gastrectomy

Objective:To explore the ideal digestive reconstruction for proximal gastrectomy of proximal gastric cancer.Methods:From 1995 to 2006, 145 cases of stage Ⅰ and Ⅱ proximal gastric cancer received subtotal proximal gastrectomy were randomized into two methods of digestive reconstruction, including esophagogastrectomy (73 cases) and jejunal interposition (72 cases). The mean operating duration, bleeding volume, and postoperation complication were compared. The quality of life, rate of reflux esophagitis, and nutritional status were also investigated one year after the operation.Results:The mean operating duration was 140±75 minutes in the esophogogastrectomy group and 220±48 minutes in the jejunal interposition group respectively(P0.01). There were no differences of the bleeding volume and complication in the two groups. One year postoperation, the quality of life in the patients with jejunal interposition was better than that with esophagogastrostomy, and the rate of reflux esophagitis in the jejunal interposition was significantly lower than that in the esophagogastratomy group. There was no significant difference about the nutritional status in the two groups.Conclusion:Jejunal interposition is an ideal digestive reconstruction after proximal gastrectomy for proximal gastric cancer.