Laparoscopic transhiatal proximal gastrectomy for adenocarcinoma of the esophagogastric junction: report of 98 cases

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Author:
REN Ming-yang(Department of Gastrointestinal Surgery, The Second Clinical Institute, North Sichuan Medical College,Sichuang Nanchong 637000, China)
HUANG Bin(Department of Gastrointestinal Surgery, The Second Clinical Institute, North Sichuan Medical College,Sichuang Nanchong 637000, China)
ZHANG Jun(Department of Gastrointestinal Surgery, The Second Clinical Institute, North Sichuan Medical College,Sichuang Nanchong 637000, China)
PU Min(Department of Gastrointestinal Surgery, The Second Clinical Institute, North Sichuan Medical College,Sichuang Nanchong 637000, China)
DENG Si-han(Department of Gastrointestinal Surgery, The Second Clinical Institute, North Sichuan Medical College,Sichuang Nanchong 637000, China)
Journal Title:
Chinese Journal of Gastrointestinal Surgery
Issue:
Volume 15, Issue 09, 2012
DOI:
10.3760/cma.j.issn.1671-0274.2012.09.010
Key Word:
Adenocarcinoma of the esophagogastric junction; Laparoscopic operation;Transhiatal proximal gastrectomy; Treatment outcomes

Abstract: Objective To explore the safety and short-term efficacy of laparoscopic transhiatal proximal gastrectomy in patients with adenocarcinoma of the esophagogastric junction.Methods From Aug 2008 to May 2011,98 patients with adenocarcinoma of the esophagogastric junction underwent laparoscopic transhiatal proximal gastrectomy.Clinical data were analyzed retrospectively including operative time,estimated bleeding,length of resection,lymph node dissection,and short-term postoperative complications.Results Ninety-six patients underwent laparoscopic transhiatal proximal gastrectomy successfully and 2 were converted to open operation (one for combined splenectomy and the other combined splenectomy and resection of the tail of the pancreas).The mean operative time was (224.1±33.7) min and the mean blood loss was (69.4±26.1) ml.The mean length of esophageal resection was (4.0±0.6) cm and the resection margin was negative.The number of lymph node removed was 16.4± 5.7.Pleural laceration occurred in 14 cases and spleen injury occurred in 3 case during operation.There was one anastomotic leakage.There were no postoperative mortalities,bleeding,anastomotic stenosis and wound infection.After follow-up ranging from 3 to 30 months,the value of reflux diagnostic questionnaire (RDQ) was 9.9±4.4 at 1 month and 9.3±4.3 at 3 months postoperatively.No incision metastasis was found and 5 patients died.Conclusion Laparoscopic transhiatal proximal gastrectomy is safe for patients with adenocarcinoma of the esophagogastric junction and the short-term clinical outcomes are favorable.

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