Clinical Outcomes of Laparoscopic Proximal Qastrectomy with Double Tract Reconstruction in Early Stage of Siewert type II for Adenocarcinoma of Esophagogastric Junction

Objective: The aim of the current study was to investigate the surgical related complication rates, nutritional status, prognosis and the quality of daily life following laparoscopic proximal gastrectomy(LPG)with double tract reconstruction in comparisonto those of laparoscopic total gastrectomy(LTG) for Siewert type II adenocarcinoma of esophagogastric junctionin three tertiary institutions. Methods: We compared the postoperative outcomes of the two surgical approaches using a well-characterized cohort of early stage gastric carcinoma patients through a retrospective reviewbetweenJanuary2017, and December2018. Both groups were compared regarding patient characteristics, surgical results, the change of body mass index, serum hemoglobinalbumin, vitaminB12and quality of life(qol).Qol was assessed by the Chinese version ofQuality of Life Questionnaire Oesophagogastric-25(QLQ-OG25). The incidence of reflux esophagitis, dumping syndrome, and retention syndrome, were also compared to evaluate postoperative restoration. Results: Both study groups were comparable with respect to general patient characteristics. No mortality and no significant differences were found for qol and surgery- related data except operation time(p < 0.05). The LPG group was associated with a better recovery of body max index ,a fewer incidence of reflux complications and better nutrition parameters (p < 0.05) than the LTG group. Conclusions: In this study, double tract reconstruction after a LPG procedure is safe for gastro esophageal junction cancer. It is superior to the LTG with respect to less incidence of reflux disease,better body weight and improved postoperative nutrition status.