Universität zu Köln

Zhu, Chun-Chao, Cao, Hui, Berlth, Felix, Xu, Jia, Park, Shin-Hoo, Choe, Hwi-Nyeong, Suh, Yun-Suhk, Kong, Seong-Ho, Lee, Hyuk-Joon, Kim, Woo-Ho and Yang, Han-Kwang (2019). Pylorus-preserving gastrectomy for early cancer involving the upper third: can we go higher? Gastric Cancer, 22 (4). S. 881 - 892. NEW YORK: SPRINGER. ISSN 1436-3305

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Abstract

BackgroundPylorus-preserving gastrectomy (PPG) is commonly performed for early gastric cancer (EGC) located in middle third of the stomach. We investigated the surgical, oncological, and functional outcomes of PPG involving the upper third of stomach.MethodsWe included all patients of the period 2013-2016 who underwent PPG, distal subtotal gastrectomy (DSG), and total gastrectomy (TG) for EGC involving the upper third by carefully defining the localization. Surgical, oncological, and functional outcome analyses included postoperative morbidity, lymph-node metastasis, tumor recurrence, postoperative body weight, body mass index, hemoglobin, total protein, albumin, quantification of intraabdominal fat, and gallstone development.ResultsOverall, 288 cases were analyzed: 145 PPG, 61 DSG, and 82 TG. In the study period, patients potentially underwent PPG for EGC involving the upper third, if enough proximal remnant stomach was found whilst achieving a sufficient proximal margin. PPG resulted in less operation time (p<0.001), less blood loss (p=0.002) and lower postoperative morbidity compared to TG. For lymph-node (LN) stations being resected in all groups, no difference was found in number of resected LN. Recurrence-free survival was similar for all groups. PPG showed advantages regarding postoperative body weight, hemoglobin, total protein, albumin in postoperative 6 and 12month follow-up. Lowest decrease of abdominal fat area after 12months was seen for PPG. Gallstone incidence was significantly lower after PPG compared to TG (p<0.001).ConclusionsFor EGC involving the upper third, PPG can be another good option with lower postoperative morbidity, better functional outcomes, and same oncological safety.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zhu, Chun-Chao UNSPECIFIED UNSPECIFIED UNSPECIFIED Cao, Hui UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlth, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Xu, Jia UNSPECIFIED UNSPECIFIED UNSPECIFIED Park, Shin-Hoo UNSPECIFIED UNSPECIFIED UNSPECIFIED Choe, Hwi-Nyeong UNSPECIFIED UNSPECIFIED UNSPECIFIED Suh, Yun-Suhk UNSPECIFIED UNSPECIFIED UNSPECIFIED Kong, Seong-Ho UNSPECIFIED UNSPECIFIED UNSPECIFIED Lee, Hyuk-Joon UNSPECIFIED UNSPECIFIED UNSPECIFIED Kim, Woo-Ho UNSPECIFIED UNSPECIFIED UNSPECIFIED Yang, Han-Kwang UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-136952
DOI:	10.1007/s10120-018-00921-9
Journal or Publication Title:	Gastric Cancer
Volume:	22
Number:	4
Page Range:	S. 881 - 892
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1436-3305
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EARLY GASTRIC-CANCER; QUALITY-OF-LIFE; SURGICAL COMPLICATIONS; SUBTOTAL GASTRECTOMY; DISTAL GASTRECTOMY; NUTRITIONAL-STATUS; HEPATIC BRANCHES; BODY-COMPOSITION; ADIPOSE-TISSUE; VAGAL NERVE Multiple languages Oncology; Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13695