title: Clinical outcome of proximal gastrectomy in patients with early gastric cancer in the upper third of the stomach.
abstract: OBJECTIVE
  To determine whether clinical outcomes after proximal gastrectomy are better than those after total gastrectomy with Roux-en Y reconstruction.
  
  
  METHODS
  We studied 10 consecutive patients with early gastric cancer who underwent esophagogastrostomy after proximal gastrectomy (PG group). Nutritional variables in these patients were compared with those in 10 consecutive patients who underwent Roux-en Y reconstruction after total gastrectomy (TG group). Patients were followed up for 5 years after operation.
  
  
  RESULTS
  There was no anastomotic leakage. The total cholesterol level 1 year after operation was higher in the PG group than in the TG group (p< 0.05). Body mass index was significantly lower than the preoperative value between 1 month and 2 years postoperation in the PG group, whereas the TG group showed decreases between 3 months to 5 years postoperation. The percent decreases in body weight at 3 and 4 years in the PG group were lower than those in the TG group (both p< 0.05). Postoperative weight loss was thus milder in the PG group than in the TG group.
  
  
  CONCLUSIONS
  Esophagogastrostomy after PG may produce better clinical outcomes than Roux-en Y reconstruction after TG in patients with early gastric cancer arising in the upper third of the stomach.
authors.affiliation: Department of Surgery, Tokai University Tokyo Hospital, Department of Gastrointestinal Surgery, Tokai University School of Medicine, Tokyo, Japan. ykondoh@tok.u-tokai.ac.jp
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Kondoh
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; D000713:Anastomosis, Roux-en-Y; D057868:Anastomotic Leak; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome