Laparoscopic Proximal Gastrectomy with Jejunal Interposition for Early Proximal Gastric Cancer.

ABSTRACT

PURPOSE: Proximal gastrectomy has been more advantageous than total gastrectomy in early cancer in the upper third of the stomach. Jejunal interposition is a novel reconstruction technique to prevent reflux esophagitis and anastomotic stricture in proximal gastrectomy. The combination of these two procedures via laparoscopic approach is not yet widespread. Therefore, this study is to evaluate the feasibility and safety of this surgery. METHODS: This is a retrospective study on eight patients with laparoscopic proximal gastrectomy and jejunal interposition for early proximal gastric cancer. Patients were followed up at 1, 3, and 6 months and then at 6-month intervals to investigate complications, recurrence, metastasis, and survival. RESULTS: All cases were adenocarcinoma in the early stage (cT1N0M0). The median (range) operating time and postoperative hospital stay were 145 min (120-210) and 7 days (6-9), respectively. No complication (including reflux esophagitis and anastomotic stricture) occurred. All patients were alive without any recurrence or metastasis during the median follow-up of 28 months (ranged 6-40 months). CONCLUSION: Laparoscopic proximal gastrectomy with jejunal interposition for early gastric cancer is safe and feasible with good long-term outcomes. Further large studies are required to evaluate the safety and efficacy of this procedure.