title: Comparative study of clinical outcomes between laparoscopy-assisted proximal gastrectomy (LAPG) and laparoscopy-assisted total gastrectomy (LATG) for proximal gastric cancer.
abstract: BACKGROUND
  The choice of surgical strategy for patients with proximal gastric cancer is controversial. The purpose of this study was to assess the feasibility, safety, and surgical and functional outcomes of laparoscopy-assisted proximal gastrectomy (LAPG) and laparoscopy-assisted total gastrectomy (LATG).
  
  
  METHODS
  Between June 2003 and December 2009, 131 patients with proximal gastric cancer underwent LAPG (n = 50) or LATG (n = 81) at Seoul National University Bundang Hospital. We reviewed their medical and surgical records from our prospectively collected gastric cancer database. The clinicopathologic characteristics and short-term, long-term, and functional outcomes were compared between the 2 groups.
  
  
  RESULTS
  There were no significant differences in demographics, T-stage, N-stage, or survival between the 2 groups. The LAPG group had a shorter operative time and lower estimated blood loss than the LATG group. The early complication rates after the LAPG and LATG procedures were 24.0 and 17.3%, respectively (p = 0.349). The incidence of reflux symptoms was significantly higher in the LAPG group (32.0 vs. 3.7%, p < 0.001). The parameters that reflected nutritional status were similar in the 2 groups.
  
  
  CONCLUSIONS
  LAPG is a feasible and acceptable method for treating proximal early gastric cancer in terms of surgical and oncologic safety. However, esophagogastrostomy after LAPG was associated with an increased risk of reflux symptoms. Antireflux procedures should be considered to prevent reflux symptoms after LAPG.
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: Sang-Hoon
authors: SH
authors: Ahn
authors: Ju Hee
authors: JH
authors: Lee
authors: Do Joong
authors: DJ
authors: Park
authors: Hyung-Ho
authors: HH
authors: Kim
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D016208:Databases, Factual; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D056910:Republic of Korea; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors