Size-dependent differences in the proximal remnant stomach: how much does a small remnant stomach after subtotal gastrec
- PDF / 1,166,765 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 55 Downloads / 145 Views
and Other Interventional Techniques
Size‑dependent differences in the proximal remnant stomach: how much does a small remnant stomach after subtotal gastrectomy work? Itaru Yasufuku1 · Manabu Ohashi1 · Kojiro Eto1 · Satoshi Ida1 · Koshi Kumagai1 · Souya Nunobe1 · Takeshi Sano1 · Naoki Hiki1 Received: 29 March 2019 / Accepted: 24 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background The application of laparoscopic subtotal gastrectomy (LsTG) in the management of early gastric cancer located in the upper third of the stomach creates an extremely small remnant stomach (SRS). However, it is unclear whether retaining such an SRS improves patients’ postoperative outcomes in a similar manner to a conventional remnant stomach (CRS). Methods Four hundred and nine of 878 patients undergoing laparoscopic distal gastrectomy (LDG) between 2006 and 2012 underwent Roux-en-Y reconstruction. Among them, we selected 73 patients who underwent LsTG with an SRS (SRS group), and 83 patients with the tumor in the lower third of the stomach who underwent LDG with a CRS (CRS group). The surgical outcomes at 1 and 6 months, 1, 2, and 3 years after gastrectomy were retrospectively analyzed and compared between the two groups. Results One year after gastrectomy, the postoperative:preoperative bodyweight ratio of the SRS group was 2% lower than that of the CRS group. Both groups had comparable total protein and albumin levels, and incidence of reflux esophagitis; however, hemoglobin was lower in the SRS group. This difference in hemoglobin level between the SRS and CRS groups became larger over time, although the total protein and albumin levels of the two groups remained similar. Conclusion An SRS slightly decreases bodyweight and hemoglobin level compared with a CRS. Several objective outcomes of the SRS group are almost equal to those of the CRS group, which suggests LsTG is worth performing even though its remnant stomach is very small. Keywords Gastric cancer · Laparoscopic distal gastrectomy · Remnant stomach · Bodyweight · Hemoglobin The incidence of early gastric cancer (EGC) located in the upper third of the stomach has recently increased in Western countries [1]. Tumors in this location are treated via minimally invasive procedures including laparoscopic total gastrectomy or laparoscopic proximal gastrectomy. However, these procedures are associated with a high incidence of complications related to esophagogastrostomy or
Itaru Yasufuku and Manabu Ohashi were equally contributed to this work. * Manabu Ohashi [email protected] 1
Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3‑8‑31 Ariake, Koto‑ku, Tokyo 135‑8551, Japan
esophagojejunostomy, and the postoperative symptoms and nutritional outcomes are unsatisfactory [2–7]. The feasibility and safety of laparoscopic distal gastrectomy (LDG) for EGC has been reported in many studies [8–16]. Laparoscopic subtotal gastrectomy (LsTG) is a novel procedure appli
Data Loading...
