676P - Clinical experience of modified gastroesophageal anastomosis in proximal gastrectomy

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Gastric Cancer
Surgical Oncology
Radiation Oncology
Presenter Igor Shchepotin
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors I. Shchepotin, S. Kirkilevskiy, O.O. Kolesnik, A. Lukashenko, A.A. Burlaka, D. Mahmudov
  • Abdominal, National cancer institute, 03022 - Kyiv/UA



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, the selecting of an ideal alimentary canal reconstructive pattern to elevate the quality of life has become more critical.


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


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).


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.


All authors have declared no conflicts of interest.