Outcomes of laparoscopic proximal gastrectomy with jejunal interposition for proximal early gastric cancer

Abstract

Abstract Introduction: Proximal gastrectomy is one of the modified surgical approaches for early gastric cancer located in the upper stomach instead of total gastrectomy. The preserving stomach helps for storage, digestion, and absorption of food and prevents anemia. Proximal gastrectomy with jejunal interinterposition has been reported to prevent and diminuate postoperative complications, such as reflux esophagitis and anastomotic stricture. Laparoscopic proximal gastrectomy (LPG) with jejunal interposition has been reported in the world with promising results. Aim of this study is to evaluate the feasibility and results of LPG with jejunal interposition for proximal early gastric cancer. Material and Methods: Descriptive prospective study ofconsecutive cases of laparoscopic proximal gastrectomy for early gastric cancer located in the upper stomach was conducted at Department of Digestive Surgery of Cho Ray hospital from 1/2015 to 6/2018, . Results: Of 8 cases of LPG for early gastric cancer located in the upper stomach was enrolled. Patients mean age was 55,5. Male/female ratio was 3/1. Tumor located at cardia in 7 cases and in fundus in 1 case. All the tumors were adenocarcinoma at cT1N0M0 stage. Mean operative time was 150 minutes. There was no intraoperative accident. Mean harvested lymph nodes were 5. There was no lymph node metastasis. No morbidity was noted. Mean postoperative hospital stay was 7 days. All patients tolerated well with food and have no regurgitation. With mean follow-up period of 28 months, there was no recurrence and mortality. Conclusion: Our initial case series demonstrated that LPG with jejunal interposition is a feasible, safe procedure and offering good functional and oncological outcomes. Futher follow-up time and more data should be needed to evaluate the effectiveness of this operation.