Y Ozaki1, Y Hiramatsu1, W Soneda1, S Kawata1, A Hirotsu1, T Murakami1, T Matsumoto1, H Kikuchi1, K Kamiya1, T Sakaguchi1, H Konno2, H Takeuchi1. 1Department of Surgery, Hamamatsu University School of Medicine, 2Hamamatsu University School of Medicine
Objective: We previously reported the usefulness of open proximal gastrectomy with jejunal interposition (OPG-IP). To provide less invasive surgery and improve postoperative QOL, we have introduced laparoscopic proximal gastrectomy with jejunal interposition (LPG-IP). Here we report the procedure and short outcome.
Patients and Methods: Early gastric cancer patients (cT1,N0) who received open total gastrectomy (OTG) (41 patients) or OPG-IP (24 patients) between 2008 and 2013 were retrospectively analyzed. Perioperative complications, body weight change, and QOL scores were measured by SF36 or GSRS before and after operation. We also analyzed 10 early gastric cancer patients who received LPG-IP with 8cm jejunal interposition. Anastomosis procedure was overlap method for eshophagojejunostomy and gastrojejunostomy, FEEA for jejuno-jejunostomy.
Results: The comparison between OTG/OPG-IP shows no significant difference in perioperative complications and QOL scores, significant smaller body weight loss in OPG-IP group. LPG-IP group also shows good result in short term outcomes.
Consideration: As comparison in open surgery implies superiority in jejunal interposition, we have introduced LPG-IP. Esophagogastrostomy after proximal gastrectomy is simple but has a risk for sever GERD symptoms, no optimal procedure for reconstruction after proximal gastrectomy has yet been established. Although laparoscopic jejunal interposition is relatively complicated in procedure, we can safely perform in combination with common anastomosis techniques.
Conclusion: Body weight loss in OTG-IP group is smaller compared to OTG group, which implies jejunal interposition method is useful to improve postoperative QOL. Although long term observation is necessary, LPG-IP can be safely performed and useful to improve postoperative QOL of proximal gastrectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87753
Program Number: P694
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster