title: Clinical outcome of esophagogastrostomy after proximal gastrectomy for gastric cancer.
abstract: OBJECTIVE
  In order to prevent reflux esophagitis after proximal gastrectomy, reconstruction by jejunal interposition (EJ) is often performed; however, this procedure is considered to be extremely complex. The purpose of this research is to consider the indication and usefulness of esophagogastrostomy (EG), as a less-invasive method of reconstruction.
  
  
  METHODS
  From 1999, 64 proximal gastrectomy cases have been reviewed. In 46 cases, EG combined with a reflux prevention procedure was performed while in the remaining 18 cases, EJ was performed. An endoscopic examination was conducted 1 year after surgery in all cases.
  
  
  RESULTS
  Compared to EJ, EG required less surgical time, thus resulting in less blood loss. Reflux esophagitis was frequently present in the EG cases (22 vs. 11%). In the EG group, 36 cases involving abdominal esophagus (AE) conservation due to the site of the cancer in comparison to the resection group (10), experienced a lower probability of reflux esophagitis (5.6 vs. 60%) and endoscopic examinations showed a lower severity (Grade B,C,D; 0 vs. 50%).
  
  
  CONCLUSIONS
  EG combined with a reflux prevention procedure is simple and less invasive. In cases in which the conservation of AE is possible, less reflux esophagitis is observed and EG is therefore recommended as an appropriate reconstruction method.
authors.affiliation: Department of Surgery, Tokyo Women's Medical University, Tokyo, Japan. seshimo@surg2.twmu.ac.jp
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Seshimo
authors.forename: Kunitomo
authors.initials: K
authors.lastname: Miyake
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Amano
authors.forename: Kazuki
authors.initials: K
authors.lastname: Aratake
authors.forename: Shingo
authors.initials: S
authors.lastname: Kameoka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004942:Esophagitis, Peptic / Q000209:etiology / Q000517:prevention & control*; D004946:Esophagostomy / Q000009:adverse effects; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D005773:Gastroscopy; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome