Comparison of short-term efficacy and quality of life of different digestive tract reconstruction methods in radical resection of proximal gastric cancer
Objective To compare the short-term clinical effects and postoperative life of different digestive tract reconstruction af-ter radical gastrectomy for proximal gastric cancer.Methods From January 2019 to December 2021,160 patients with upper gastric cancer and esophagogastric junction cancer were treated by radical surgery in tumor hospital affiliated to Xinjiang Medical University.Among them,80 patients underwent total gastrectomy,Roux-en-Y anastomosis,80 patients underwent proximal gastrectomy.Among them,34 patients underwent gastric tube esophagogastrostomy(GT),18 patients underwent jejunal interposition(JI)and 28 patients un-derwent double-tract reconstruction(DTR).Basic data,surgery-related indexes,postoperative recovery indexes and related complica-tions were compared between the two groups of patients who underwent total gastrectomy or proximal gastrectomy.The quality of life of each group 1 year after surgery was assessed by Visick scale and EORTCQLQ-C30.Results Compared with proximal gastrectomy,the operation time of esophagojejunostomy patients was shorter(P<0.05).Compared with esophagojejunostomy,different proximal gastro-intestinal reconstruction had no difference in surgical control such as blood loss and sweeping number(P<0.05).Compared with JI group and DTR group,the time of starting liquid diet was earlier and the time of hospitalization was shorter in the esophagojejunostomy group and GT group(P<0.01).There was no significant difference in the incidence of early complications among the groups(P>0.05).JI group and DTR group showed the advantage of anti-reflux in the early stage,but with the prolongation of postoperative recov-ery time,the patients adapted to the postoperative diet and habit of gastroesophageal reflux symptoms in GT group showed a better im-provement trend.The results of EORTC QLQ-C30 questionnaire 1 year after operation showed that the patients in the DTR group and the JI group were better than those in the total health status,physical function,role function,emotional function and cognitive function(P<0.05).Conclusion Gastric tube esophagogastrostomy,jejunal interposition and double-tract reconstruction are more feasible than total gastrectomy esophagojejunostomy in the treatment of proximal gastric cancer.They all show good short-term curative effect and improve postoperative reflux symptoms and improve patients'life.
Proximal gastric cancerDigestive tract reconstructionQuality of life assessment
万方数据
维普
