title: Esophagogastrostomy reconstruction after limited proximal gastrectomy.
abstract: OBJECTIVE
  Recent advances in diagnostic techniques have led to the detection of an increasing number of early gastric cancers in the upper third of the stomach. The objective of this study was to determine the most appropriate surgical treatment for these cancers.
  
  
  METHODS
  The clinicopathologic characteristics of 35 patients with early gastric cancer in the upper third of the stomach who underwent three different types of gastrectomies were reviewed retrospectively from hospital records between January 1992 and August 1999.
  
  
  RESULTS
  Patients undergoing limited proximal gastrectomy with esophagogastrostomy reconstruction had shorter operation times and less blood loss than those for patients undergoing total gastrectomy or proximal gastrectomy with jejunal interposition. No lymph node metastasis was identified in any of these patients. Heartburn due to reflux esophagitis was seen in a few patients of each group, but they were successfully treated by antacids. The extreme reduction in food intake volume was more frequently experienced in patients with total gastrectomy than those with both proximal gastrectomies. When mortality due to other disease was excluded, all patients survived without recurrence.
  
  
  CONCLUSIONS
  A limited proximal gastrectomy with esophagogastrostomy reconstruction decreased surgical risk and realized preservation of maximal function.
authors.affiliation: Department of Surgery, Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto 605-0981, Japan. dichykawa@nifty.com
authors.forename: D
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Y
authors.initials: Y
authors.lastname: Ueshima
authors.forename: K
authors.initials: K
authors.lastname: Shirono
authors.forename: K
authors.initials: K
authors.lastname: Kan
authors.forename: Y
authors.initials: Y
authors.lastname: Shioaki
authors.forename: C J
authors.initials: CJ
authors.lastname: Lee
authors.forename: T
authors.initials: T
authors.lastname: Hamashima
authors.forename: E
authors.initials: E
authors.lastname: Deguchi
authors.forename: E
authors.initials: E
authors.lastname: Ikeda
authors.forename: F
authors.initials: F
authors.lastname: Mutoh
authors.forename: T
authors.initials: T
authors.lastname: Oka
authors.forename: H
authors.initials: H
authors.lastname: Kurioka
mesh_terms: D004946:Esophagostomy; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome