Abstract：【Objective】To compare total gastrectomy and Proximal gastrectomy for locally advanced Siewert Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG) . 【Methods】 A total of 122 patients with locally advanced Siewert Ⅱ and Ⅲ AEG treated in Shaanxi Cancer Hospital from October 2015 to October 2018 were randomly divided into control group and observation group, with 61 cases in each group. The control group was treated with proximal subtotal gastrectomy, the observation group was treated with total gastrectomy, and the patients were followed up for 36 months The operation and postoperative recovery of the two groups were compared, the preoperative and postoperative quality of life scores of the two groups were recorded, and the incidence of postoperative complications and 36 month overall survival rate were counted. 【Results】The operation time, the number of lymph nodes and the number of positive lymph nodes in the observation group were higher than those in the control group; The first exhaust time, recovery time of bowel sounds and first eating time in the postoperative group were shorter than those in the control group, The scores of the special scale for esophageal and gastric junction cancer (QLQ-OG25) 12 months after operation in the two groups were lower than those before operation, and the observation group was significantly lower than that in the control group (P<0.05).The 36 month overall survival rate of the observation group was 65.52%, which had no significant difference compared with 69.49% of the control group (P>0.05). 【Conclusion】 Total gastrectomy and proximal subtotal gastrectomy can achieve similar survival rates in the treatment of locally advanced Siewert Ⅱ and Ⅲ AEG, but total gastrectomy has better lymph node dissection effect, higher quality of life and good safety, which is conducive to postoperative recovery.
冯海波, 卢喜卫. 全胃切除术和近端胃大部分切除术治疗局部进展期Siewert Ⅱ型和Ⅲ型食管胃结合部腺癌的疗效比较[J]. 医学临床研究, 2021, 38(12): 1806-1809.
FENG Hai-bo, LU Xi-wei. Comparison of Total Gastrectomy and Subtotal Gastrectomy in the Treatment of Locally Advanced Siewert Ⅱ and Ⅲ AEG. JOURNAL OF CLINICAL RESEARCH, 2021, 38(12): 1806-1809.
[1] KUMAMOTO T, KURAHASHI Y, NIWA H, et al. True esophagogastric junction adenocarcinoma: background of its definition and current surgical trends[J].Surg Today,2020, 50(8):809-814.
[2] JUNQUERA F, FERNANDEZ-ANANIN S, BALAGUE C. Therapeutic options for early cancer of the esophagogastric junction[J].Cir Esp,2019, 97(8):438-444.
[3] BANG Y J, KANG Y K, CATENACCI D V, et al. Pembrolizumab alone or in combination with chemotherapy as first-line therapy for patients with advanced gastric or gastroesophageal junction adenocarcinoma: results from the phase II nonrandomized KEYNOTE-059 study[J].Gastric Cancer,2019, 22(4):828-837.
[4] HOLSCHER A H, LAW S. Esophagogastric junction adenocarcinomas: individualization of resection with special considerations for Siewert type II, and Nishi types EG, EG and GE cancers[J].Gastric Cancer,2020, 23(1):3-9.
[5] ZHANG S, ORITA H, FUKUNAGA T. Current surgical treatment of esophagogastric junction adenocarcinoma[J].World J Gastrointest Oncol,2019, 11(8):567-578.
[6] GOCKEL I, LORDICK F, LYROS O, et al. Pretherapeutic misclassification of esophageal cancer and adenocarcinoma of the esophagogastric junction : Possibilities and clinical consequences[J]. Chirurg, 2020, 91(1):41-50.
[7] CHEN X D, HE F Q, LIAO M S, et al. Laparoscopic versus open transhiatal approach for adenocarcinoma of the esophagogastric junction: A systematic review and meta-analysis[J].Eur J Surg Oncol,2021, 47(4):778-788.
[8] AJANI J A, D'AMICO T A, ALMHANNA K, et al. Esophageal and esophagogastric junction cancers, version 1.2015[J].J Natl Compr Canc Netw,2015, 13(2):194-227.
[9] RELVAS-SILVA M, SILVA R A, DINIS-RIBEIRO M. Portuguese version of the EORTC QLQ-OES18 and QLQ-OG25 for health-related quality of life assessment[J].Acta Med Port,2017, 30(1):47-52.
[10] TREPPIEDI E, GIACOPUZZI S, DE PASCALE S. Adenocarcinoma of the esophagogastric junction; going up or down[J].Gastric Cancer,2020, 23(5):948-949.
[11] KANO Y, OHASHI M, IDA S, et al. Laparoscopic proximal gastrectomy with double-flap technique versus laparoscopic subtotal gastrectomy for proximal early gastric cancer[J].BJS Open,2020, 4(2):252-259.
[12] VORON T, GRONNIER C, PASQUER A, et al. Adenocarcinoma of the esophagogastric junction Siewert Ⅱ: An esophageal cancer better cured with total gastrectomy[J]. Eur J Surg Oncol,2019, 45(12):2473-2481.
[13] LIAO C, FENG Q, XIE S, et al. Laparoscopic versus open gastrectomy for Siewert type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction: A meta-analysis[J].Surg Endosc, 2021, 35(2):860-871.
2021, Vol. 38 
