P-0078 - Modified gastroesophageal anastomosis in proximal gastrectomy

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Gastric Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Ighor Shchepotin
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors S. Kirkilevskiy
  • National Cancer Institute, Kyiv/UA

Abstract

Introduction

The incidence of proximal gastric cancer has increased and it is known, that after proximal gastrectomy, postgastrectomy syndromes are still more or less unavoidable. That is why selecting an ideal alimentary canal reconstructive pattern to elevate the quality of life has become more critical.

Methods

All 324 patients were randomized in three groups by type of gastroesophageal anastomosis use during proximal gastrectomy (PGE), (stapler (S), hand-sutured standard anastomosis by Ivor Lewis (HSA) or modified antireflux hand-sutured anastomosis (MAHSA)).

Results

Endoscopic control at 1 year follow-up of S group showed reflux esophagitis with the following distributions: 40,6%, 30,2% and 13,2%; the same control in HSA group show 17,3%, 13,5% and 8,6% for grade A, B and C respectively. In contrast endoscopic control of MAHSA group showed reflux disease grade A and B only in 14,1% and 1,7% respectively. The evaluation scores measured by the EORTC QOL gastric cancer–specific questionnaire (QLQ-25) for acid indigestion or heartburn and acid or bile coming into mouth in main group MAHSA were 1.2 ± 0.08; 1.2 ± 0.08 whereas in groups HSA and S they were 1.8 ± 0.1; 1.8 ± 0.2 and 2.2 ± 0.2; 1.8 ± 0.1 respectively (p < 0.05).

Conclusion

Our data showed that the presented modified method of esophagogastric anastomosis forming is a safe, easy to implement and effective in preventing the development of reflux after PGE for cancer of the upper third of the stomach.