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The following is a summary of “Comparison of proximal gastrectomy with tubular esophagogastric anastomosis and total gastrectomy with Roux-en-Y reconstruction in the treatment of adenocarcinoma of the esophagogastric junction of Siewert type II/III at stage II,” published in the November 2024 issue of Surgery by Zhang et al.     

Tubular anastomosis is commonly used in proximal gastrectomy (PG), but the effectiveness in stage II adenocarcinoma of the esophagogastric junction (AEG) remains unclear.  

Researchers conducted a retrospective study comparing the outcomes of PG with tubular esophagogastric anastomosis (PG-TEA) vs. total gastrectomy with Roux-en-Y reconstruction (TG-RY) for stage II Siewert type II/III AEG.  

They analyzed the clinical data of 43 patients undergoing PG-TEA and 80 TG-RY (October 2015 to October 2018), comparing clinical characteristics, postoperative QoL, nutritional status, and long-term survival outcomes.  

The results showed no notable change between the 2 groups in baseline data. The PG-TEA group had a shorter operation time, less intraoperative bleeding, and earlier feeding, which helped recovery. Reflux esophagitis was more frequent in the PG-TEA group, with no significant difference in anastomotic ulcers or other complications, 3 months post-surgery, the PG-TEA group had better nutritional status than the TG-RY group (P<0.05), no significant differences were observed by 6 months. The PG-TEA group had fewer incidences of diarrhea and dumping syndrome and higher satisfaction with daily life and meals. No significant difference in OS between the 2 groups (P>0.05).  

They concluded that PG-TEA achieved similar outcomes to TG-RY in stage II Siewert type II/III AEG and can be applied clinically.  

Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-024-02685-9