Proximal gastrectomy and jejunal pouch interposition for the treatment of early cancer in the upper third of the stomach: surgical techniques and evaluation of postoperative function.
BACKGROUND
Limited surgery for the treatment of early gastric cancer located in the upper third of the stomach should be based on a well-balanced reduction in the extent of lymph node dissection and gastric resection while assuring a favorable quality of life and prognosis after operation.


METHODS
We have used interposition of a double jejunal pouch between the esophagus and the remnant stomach after performing proximal gastrectomy. To assure anastomosis and hemostasis during this operation, we currently use a surgical stapler with a vaginoscope and our new edge clamps. This method has been used in 12 patients to date.


RESULTS
On histopathologic examination the 12 cases comprised 11 early cancers (seven mucosal and four submucosal cancers) and one subserosal cancer. There was no evidence of lymph node metastasis of postoperative complications such as anastomotic leakages or hemorrhage, demonstrating the low-risk nature of this procedure.


CONCLUSIONS
The evaluation of postoperative quality of life, in terms of clinical signs and symptoms and dietary status, yielded favorable results. Thus our method has the important advantage of allowing good organ preservation.
Takeshita
K
K
Department of Surgery, Tokyo Medical and Dental University School of Medicine, Tokyo, Japan.
Saito
N
N
Saeki
I
I
Honda
T
T
Tani
M
M
Kando
F
F
Endo
M
M
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001464:Barium; D004724:Endoscopy; D005069:Evaluation Studies as Topic; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013274:Stomach Neoplasms / Q000601:surgery*
D001464:Barium