Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 30;408(1):69.
doi: 10.1007/s00423-023-02779-7.

Safety and efficacy of laparoscopic proximal gastrectomy with SOFY versus laparoscopic total gastrectomy with Roux-en-Y for treating cT1-2 Siewert II/III adenocarcinoma of the esophagogastric junction: a single-center prospective cohort study

Haiqiao Zhang  1 , Zhi Zheng  1 , Xiaoye Liu  1 , Chenglin Xin  1 , Yong Huang  1 , Yuan Li  1 , Jie Yin  2 , Jun Zhang  3
Affiliations

Safety and efficacy of laparoscopic proximal gastrectomy with SOFY versus laparoscopic total gastrectomy with Roux-en-Y for treating cT1-2 Siewert II/III adenocarcinoma of the esophagogastric junction: a single-center prospective cohort study

Haiqiao Zhang et al. Langenbecks Arch Surg. .

Abstract

Purpose: Side overlap with fundoplication by Yamashita (SOFY) is an anti-reflux form of esophagogastrostomy. We compared the safety and efficacy of laparoscopic proximal gastrectomy (PG) with SOFY to that of laparoscopic total gastrectomy (TG) with Roux-en-Y for treating cT1-2 Siewert II/III adenocarcinoma of the esophagogastric junction.

Methods: Fifty-two patients who underwent PG (n = 28) or TG (n = 24), without conversion to laparotomy, were included. Surgical outcomes, complications, reflux symptoms, quality of life, and nutritional status of both groups were compared.

Results: Significant differences between PG and TG groups regarding operative time (245.7 versus 294.6 min, P = 0.005), reconstruction time (22.1 versus 28.5 min, P < 0.001), time to pass gas (3 versus 4 days, P = 0.021), time to oral intake (4.5 versus 5 days, P = 0.043), and gastroesophageal reflux (60.7% versus 4.2%, P < 0.001) were observed. Reflux esophagitis for the PG group was 42.9% (12/28). The incidence of Los Angeles grade B and above was 10.7%. Between-group differences in terms of global health status, diarrhea, reflux, and eating were observed. Body weight maintenance was better in the PG group than in the TG group 6 months and 1 year postoperatively.

Conclusion: SOFY is simple and more advantageous than TG in terms of postoperative recovery, body weight, eating, and diarrhea. However, the occurrence of postoperative reflux after SOFY was high. The limitations of this study are the significant differences in pathological T stage of patients in the two groups and the small sample size.

Keywords: Nutritional status; Proximal gastrectomy; Quality of life; Reflux esophagitis; Total gastrectomy.

PubMed Disclaimer

References

    1. Sung H, Ferlay J, Siegel RL et al (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249 - PubMed
    1. Hatta W, Tong D, Lee YY et al (2017) Different time trend and management of esophagogastric junction adenocarcinoma in three Asian countries. Dig Endosc 29(Suppl 2):18–25 - PubMed
    1. Japanese Gastric Cancer Association (2021) Japanese gastric cancer treatment guidelines 2018, 5th ed. Gastric Cancer 24(1):1–21
    1. Toyomasu Y, Mochiki E, Ishiguro T et al (2021) Clinical outcomes of gastric tube reconstruction following laparoscopic proximal gastrectomy for early gastric cancer in the upper third of the stomach: experience with 100 consecutive cases. Langenbecks Arch Surg 406(3):659–666 - PubMed
    1. Xiang R, Song W, Ren J et al (2021) Proximal gastrectomy with double-tract reconstruction versus total gastrectomy for proximal early gastric cancer: a systematic review and meta-analysis. Medicine (Baltimore) 100(45):e27818 - PubMed

LinkOut - more resources