Jagric Tomaz1* and Jagric Timotej2
1University Medical Centre Maribor, Department of Abdominal and General Surgery, Slovenia
2Department for Quantitative Economic Analysis, Faculty of Economics and Business, University of Maribor, Slovenia
*Corresponding Author: Jagric Tomaz, University Medical Centre Maribor, Department of Abdominal and General Surgery, Slovenia.
Received: July 02, 2020; Published: August 24, 2020
Background/Aim: The theoretical functional advantages of proximal resection with jejunal interposition could outweigh the higher risk of recurrence in the unfit elderly population. The aim of our study was to evaluate proximal resection as an alternative in selected patients.
Methods: Between 1993 and 2009, 161 patients were operated on in our centre for adenocarcinoma of the proximal third of the stomach. They were divided into three groups: PG: proximal resection with jejunal interposition; TH: transhiatal extended total gastrectomy; GT: total gastrectomy. We analysed the postoperative morbidity, 30-day mortality, survival, and quality of life with a questionnaire.
Results: The patients in the PG group were significantly older and in worse general condition. The number of harvested lymph nodes was significantly smaller than in the GT and TH groups. There were no significant differences in the distribution of TNM stages between groups. There were no differences in the morbidity and 5-year survival rates between groups. No differences were found in the total scores of the GIQLI questionnaire.
Conclusion: Proximal resection should be reserved only for high-risk elderly population with proximal gastric cancer. These resections carry acceptable morbidity and mortality; however, the reconstruction with jejunal interposition does not bring the desired functional benefits.
Keywords: Gastric Adenocarcinoma; Proximal Resection; Jejunal Interposition; Quality of Life
Citation: Jagric Tomaz and Jagric Timotej. “Is the Proximal Subtotal Gastrectomy a Better Choice in Selected Patients than Radical Gastrectomy: A Comparison of Morbidity, Mortality and Survival after Surgical Treatment of Proximal Third Gastric Adenocarcinoma”. Acta Scientific Gastrointestinal Disorders 3.9 (2020): 21-29.
Copyright: © 2020 Jagric Tomaz and Jagric Timotej. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.