EVALUATION OF VARIOUS PROCEDURES OF ESOPHAGOGASTROSTOMY AND PYLOROPLASTY BASED ON QUALITY OF LIFE FOLLOWING PROXIMAL GASTRECTOMY

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  • YAMAMURA Yoshitaka
    Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
  • KODERA Yasuhiro
    Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
  • TORII Akihito
    Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
  • UESAKA Katsuhiko
    Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
  • HIRAI Takashi
    Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
  • YASUI Kenzo
    Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
  • MORIMOTO Takeshi
    Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
  • KATO Tomoyuki
    Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
  • KITO Tsuyoshi
    Department of Gastroenterological Surgery, Aichi Cancer Center Hospital

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  • 術後のquality of lifeからみた噴門側胃切除後の食道残胃吻合方法と幽門形成についての評価

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Abstract

Quality of life after surgical procedures of various types of esophagogastrostomy were retrospectively evaluated. Thirty-six patients were divided into three groups; group A (16 patients): end-to-side anastomosis with pyloroplasty, group B (14 patients): end-to-side anastomosis without pyloroplasty, and group C (6 patients): end-to-end anastomosis without pyloroplasty. There were no significant differences among these three groups in the background factors such as age, sex, invasion to the esophagus, pathological type, depth of invasion, lymph node metastasis, degree of dissection and curability. In an early phase after the surgery, smaller proportion of patients complained of vomiting while period of hospitalization was shorter in group A. In a late phase after the surgery (five years postoperatively), inadequate food intake and consequent loss of body weight were frequently observed in group B patients. 25% of group A patients maintained 100% or more of preoperative body weight. Frequent and severe heartburn was observed in group C. From these results, we conclude that the surgical procedure of end-to-side anastomosis of esophagogastrostomy combined with pyloroplasty is the most adequate mode of reconstruction following proximal gastrectomy.

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