[Comparision between proximal gastrectomy and total gastrectomy in early gastric cancer].

OBJECTIVE

The purpose of this study was to evaluate clinical outcome of proximal and total gastrectomy regarding reflux esophagitis, nutritional state, and anemia in early gastric cancer.

METHODS

94 patients with early gastric cancer were included from January 2001 to January 2007 at Chungnam National University Hospital. Of whom 40 patients (31 men and 9 woman) had proximal gastrectomy (PG) and 54 patients (44 men and 10 woman) had total gastrectomy (TG). We reviewed all their medical and surgical record with surveying for gastrointestinal symptoms and reflux symptoms over the phone.

RESULTS

There were no significant differences between basic, surgical, and histopathologic characteristics. Bile reflux symptoms and heart burn symptoms were more common and severe in the TG group. The incidences of endoscopically detected reflux esophagitis were about 60% in the TG group and about 30% in the PG group. The hemoglobin levels were significantly higher in the PG group after the operation and were gradually decreased in the TG as the time went. The levels of laboratory variables such as total protein, albumin, and total cholesterol were lower in the TG group than in the PG group after the operation. However, stoma stricture after operation developed in the PG group more often than in the TG group, and esophageal balloon dilatations were performed more frequently in the PG group.

CONCLUSIONS

PG is favorable for proximal early gastric cancer in terms of reduced reflux esophagitis, anemia, and malnutrition except the stricture at esophagogastrostomy site.