Abstract:
To compare the clinical efficacies of laparoscopic-assisted proximal gastrectomy (LAPG) and open proximal gastrectomy (OPG) for treating Siewert type Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction (AEG).
Methods The clinical data of 116 patients with Siewert type Ⅱ and Ⅲ AEG from February 2015 to February 2017 were analyzed retrospectively. Patients were grouped into the LAPG group (48 cases) and the OPG group (68 cases). The efficacy of radical resection, clinicopathological features, perioperative situation, and postoperative tumor recurrence in the two groups were compared. Patients were followed up by telephone or out-patient examination until March 2018.
Results The two groups of patients successfully underwent surgery with no perioperative death. The average operation time was (3.46±0.46) h in the LAPG group, which was longer than that in the OPG group (2.68±0.68) h. The average intraoperative bleeding volume was (108±46.8) mL, which was lower than that in the OPG group (236±86.6) mL. The gastrointestinal function recovery time was (2.56±0.56) d in the LAPG group, which was shorter than that in the OPG group (3.82±0.86) d. The average hospital stay was (12.24±1.86) d in the LAPG group, which was lower than that in the OPG group (14.68±2.89) d; P < 0.05. The proximal incision margin was longer in OPG group (3.06±0.56) cm vs. (2.38±0.86) cm, P < 0.05. There were no significant differences in the length of distal resection margins, number of lymph nodes resected, and incidence of postoperative complications between the LAPG and OPG groups (P > 0.05).
Conclusions LAPG is comparable to OPG in the treatment of Siewert type Ⅱ and ⅢAEG regarding the aspects of radical resection and tumor recurrence, but LAPG confers less bleeding, less postoperative pain, faster recovery of gastrointestinal function, and shorter hospital stay