title: Functional outcomes according to the size of the gastric remnant and type of reconstruction following open and laparoscopic proximal gastrectomy for gastric cancer.
abstract: OBJECTIVE
  We compared functional outcomes between different types of reconstruction following open or laparoscopic 1/2- or 2/3-proximal gastrectomy for gastric cancer.
  
  
  METHODS
  Resection and reconstruction were performed by one of the following 6 methods, depending on the depth of cancer invasion and the date of the procedure relative to introduction of laparoscopic proximal gastrectomy: open proximal 2/3-gastrectomy with jejunal interposition (2/3 PG-int, n=7), open proximal 1/2-gastrectomy with jejunal interposition (1/2 PG-int, n=5), laparoscopic proximal 1/2-gastrectomy followed by double tract reconstructions with small (3 cm) jejunogastrostomy (L1/2 PG-DT(S), n=19) and laparoscopic proximal 1/2-gastrectomy followed by double tract reconstructions with large (6 cm) jejunogastrostomy (L1/2PG-DT(L), n=10). Open total gastrectomy with jejunal interposition (TG, n=12) and laparoscopic total gastrectomy with Roux-en-Y reconstruction (LTG, n=14) represented control procedures.
  
  
  RESULTS
  Comparison of postoperative/preoperative body weight ratios and food intake ratios revealed better preservation among patients with a larger remnant stomach and with easy flow of food into the remnant stomach (the 1/2PG-int and L1/2PG-DT(L) groups).
  
  
  CONCLUSIONS
  Better functional outcomes were observed in patients with a large remnant stomach and with easy flow of food into the remnant stomach regardless of whether they underwent open or laparoscopic procedures.
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan. sur035@poh.osaka-med.ac.jp
authors.forename: Eiji
authors.initials: E
authors.lastname: Nomura
authors.forename: Sang-Woong
authors.initials: SW
authors.lastname: Lee
authors.forename: Takaya
authors.initials: T
authors.lastname: Tokuhara
authors.forename: Masaru
authors.initials: M
authors.lastname: Kawai
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D001835:Body Weight; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D004063:Digestion; D004435:Eating; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D018530:Gastric Stump / Q000503:physiopathology*; D005763:Gastroenterostomy; D006801:Humans; D007564:Japan; D007583:Jejunum / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome