title: Esophagogastrostomy before proximal gastrectomy in patients with early gastric cancers in the upper third of the stomach.
abstract: OBJECTIVE
  This study was designed to assess the outcome of esophagogastrostomy before proximal gastrectomy in patients with early gastric cancers in the upper third of the stomach.
  
  
  METHODS
  From 1997 through 2004, we studied 10 consecutive patients. A stapler was introduced into the stomach, and an esophagogastrostomy was performed before proximal gastrectomy. Hill's posterior gastropexy and Dor's anterior fundic wrap were performed to prevent reflux esophagitis.
  
  
  RESULTS
  The operation time was 171 ± 44 minutes, and the intraoperative bleeding volume was 294 ± 228 mL. There was no anastomotic leakage. Anastomotic stenosis, occurring in 40% of the patients, required endoscopic balloon dilatation. Symptoms of reflux esophagitis, occurring in 40% of the patients, resolved within 2 years after operation. As compared with the preoperative value, body mass index was significantly decreased 1 and 2 years after operation, but was similar at 3 to 5 years. The percent decrease in body weight after operation fluctuated between 6% and 8% between 2 and 5 years. Postoperative weight loss was thus mild.
  
  
  CONCLUSIONS
  Esophagogastrostomy before proximal gastrectomy may be less invasive, simpler, and produce better outcomes than conventional procedures for the surgical treatment of early gastric cancer in the upper third of the stomach.
authors.affiliation: Department of Surgery, Tokai University Tokyo Hospital, 1-2-5, Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan. ykondoh@tok.u-tokai.ac.jp
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Kondoh
authors.forename: Akiko
authors.initials: A
authors.lastname: Ishii
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishizu
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hanashi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Mari
authors.initials: M
authors.lastname: Morita
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Nabeshima
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.forename: Jinichi
authors.initials: J
authors.lastname: Soeda
authors.forename: Kyoji
authors.initials: K
authors.lastname: Ogoshi
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D004942:Esophagitis, Peptic / Q000517:prevention & control; D004946:Esophagostomy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000517:prevention & control; D013270:Stomach / Q000473:pathology / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome