Objective:The incidence of adenocarcinoma of the esophagogastric junction(AEG)is increasing.For patients with resectable Siewert II AEG,there is still a lack of consensus with regards to which surgical procedure can w...Objective:The incidence of adenocarcinoma of the esophagogastric junction(AEG)is increasing.For patients with resectable Siewert II AEG,there is still a lack of consensus with regards to which surgical procedure can well balance survival time and quality of life.This study aims to describe a modified double-tract reconstruction(DTR)method following laparoscopic proximal gastrectomy(LPG)and to evaluate the feasibility,safety,and effects of this novel method.Method:This study retrospectively reviewed 29 patients who received modified DTR after LPG for Siewert Ⅱ AEG at a single center between August 2015 and October 2020.Clinicopathological characteristics,surgical outcomes,nutritional status and dietary ability were analyzed.Result:The mean surgical time was 206.4±39.2 min,mean intraoperative blood loss was 175.9±41.4 mL,and median postoperative hospital stay was 11 d(range,9-70 d).The early complication rate was 13.8%(n=4),and the late complication rate was 6.9%(n=2).No reflux esophagitis or reflux symptom was recorded.There were no perioperative deaths within three months post-operatively.At the third follow-up month after surgery,most patients(25/29,86.2%)were experiencing sufficient oral food intake,with a median frequency of 5 meal/d(range,3-6 meal/d).The median total weight loss was 8 kg(range,0-15 kg)and there were no case of post-operative malnutrition.Conclusion:The modified DTR method following LPG represents a novel,safe,and feasible method that provides sufficient nutritional support with few diet-related discomforts.Prospective large-scale randomized trials are now needed to validate the clinical applicability of this method.展开更多
基金supported by the Beijing Municipal Natural Science Foundation(No.7204313)the Medical Big Data and Artificial Intelligence Project of Chinese PLA General Hospital(2019MBD-027).
文摘Objective:The incidence of adenocarcinoma of the esophagogastric junction(AEG)is increasing.For patients with resectable Siewert II AEG,there is still a lack of consensus with regards to which surgical procedure can well balance survival time and quality of life.This study aims to describe a modified double-tract reconstruction(DTR)method following laparoscopic proximal gastrectomy(LPG)and to evaluate the feasibility,safety,and effects of this novel method.Method:This study retrospectively reviewed 29 patients who received modified DTR after LPG for Siewert Ⅱ AEG at a single center between August 2015 and October 2020.Clinicopathological characteristics,surgical outcomes,nutritional status and dietary ability were analyzed.Result:The mean surgical time was 206.4±39.2 min,mean intraoperative blood loss was 175.9±41.4 mL,and median postoperative hospital stay was 11 d(range,9-70 d).The early complication rate was 13.8%(n=4),and the late complication rate was 6.9%(n=2).No reflux esophagitis or reflux symptom was recorded.There were no perioperative deaths within three months post-operatively.At the third follow-up month after surgery,most patients(25/29,86.2%)were experiencing sufficient oral food intake,with a median frequency of 5 meal/d(range,3-6 meal/d).The median total weight loss was 8 kg(range,0-15 kg)and there were no case of post-operative malnutrition.Conclusion:The modified DTR method following LPG represents a novel,safe,and feasible method that provides sufficient nutritional support with few diet-related discomforts.Prospective large-scale randomized trials are now needed to validate the clinical applicability of this method.
