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| Effect of Proximal Subtotal Gastrectomy and Jejunal Interposition Surgery on Gastrointestinal Function, Nutritional Status and Short-term Survival after proximal gastrectomy |
| LUO Liang, WU Chen, CHEN Jin, et al |
| Sichuan Mianyang 404 Hospital,Mianyang 621000 |
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Abstract 【Objective】 To investigate the effect of proximal subtotal gastrectomy and jejunal interposition surgery on gastrointestinal function, nutritional status and short-term survival after proximal gastrectomy. 【Methods】 The clinical data of 105 patients with proximal gastric cancer treated surgically in our hospital from August 2013 to May 2017 were retrospectively analyzed. According to the different treatment methods, patients were divided into the control group (n=43) and the observation group (n=62). The patients in the control group were treated with radical total gastrectomy plus esophagojejunal Roux-en-Y anastomosis. While patients in the observation group were treated with proximal subtotal gastrectomy and jejunal interposition surgery. The perioperative indicators and the incidence of complications were compared between the two groups. The gastrointestinal function was compared between the two groups as well, including the levels of gastrointestinal hormones(GAS and MLT), and the time of exhaust after operation. Nutritional status, 1-year and 2-year survival rates were recorded between the two groups. 【Results】 The operation time of the observation group was significantly longer than that of the control group (P<0.05), while the amount of bleeding and lymphatic clearance were significantly lower than those of the control group (P<0.05).There was no statistical difference in the length of incision between the two groups (P>0.05). Three months after operation, the levels of GAS and MTL in both groups were lower than those before operation, however, the level of GAS in the observation group was higher than that in the control group (P<0.05). There were no significant differences in the levels of MLT and the time of exhaust after operation between the two groups (P>0.05). The incidence of dumping syndrome, Roux detention syndrome and reflux esophagitis in the observation group was significantly lower than that in the control group (P<0.05). There was no significant difference in incision infection, pulmonary infection, abdominal infection, anastomotic leakage and intestinal obstruction between the two groups (P>0.05). The levels of hemoglobin, albumin and prognostic nutrition index (PNI) in the observation group were significantly higher than those in the control group (P<0.05). There was no statistically significant difference in 1-year and 2-year survival rates between the two groups (P>0.05). 【Conclusion】 Proximal subtotal gastrectomy and jejunal interposition surgery is more effective in the treatment of proximal gastric cancer. It can reduce the incidence of dumping syndrome, Roux retention syndrome and reflux esophagitis, which can improve nutritional status. It is an ideal method for digestive tract reconstruction after proximal gastric cancer surgery.
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Received: 25 April 2019
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2020, Vol. 37 
