title: Esophagogastrostomy plus gastrojejunostomy: a novel reconstruction procedure after curative resection for proximal gastric cancer.
abstract: OBJECTIVE
  The choice of surgical strategy for patients with proximal gastric cancer remains controversial. In this study, we recommend that a new reconstruction procedure be performed following proximal gastrectomy.
  
  
  METHODS
  We conducted a retrospective study involving 71 patients who underwent gastrectomy for proximal gastric cancer. Clinicopathological features, postoperative complications, nutritional status, and overall survival (OS) rate were compared among three different reconstruction approaches.
  
  
  RESULTS
  There were 34 cases of proximal gastrectomy followed by esophagogastrostomy reconstruction (EG), 16 cases of total gastrectomy and Roux-en Y reconstruction (RY) and 21 cases of proximal gastrectomy followed by esophagogastrostomy plus gastrojejunostomy reconstruction (EGJ). Though the clinicopathological features, the nutritional status and OS rate were similar among the three groups of patients, the incidence of reflux esophagitis was significantly higher in the EG group (35.3%) than the RY (6.2%) and EGJ (9.6%) groups(P < 0.05). Few EGJ patients suffered from either reflux esophagitis or anastomotic stenosis.
  
  
  CONCLUSIONS
  The EGJ reconstruction method helps to resolve the syndrome of reflux esophagitis. Our data indicates that it is a simple, safe, and effective reconstruction procedure for PGC.
authors.affiliation: Department of Gastrointestinal Tumor Surgery, Affiliated Tumor Hospital of Guangzhou Medical University, #78 Hengzhigang Road, Guangzhou, 510095, Guangdong Province, China.
authors.forename: Shicai
authors.initials: S
authors.lastname: Chen
authors.forename: Jianchang
authors.initials: J
authors.lastname: Li
authors.forename: Haiying
authors.initials: H
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Zeng
authors.forename: Guohua
authors.initials: G
authors.lastname: Yang
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.forename: Weiqun
authors.initials: W
authors.lastname: Lu
authors.forename: Nanrong
authors.initials: N
authors.lastname: Yu
authors.forename: Zhiliang
authors.initials: Z
authors.lastname: Huang
authors.forename: Houwei
authors.initials: H
authors.lastname: Xu
authors.forename: Xiang
authors.initials: X
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003251:Constriction, Pathologic / Q000209:etiology; D004942:Esophagitis, Peptic / Q000209:etiology; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects; D015390:Gastric Bypass / Q000009:adverse effects; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D015431:Weight Loss; D055815:Young Adult