Clinical comparison of antrum-preserving double tract reconstruction<i>vs</i>roux-en-Y reconstruction after gastrectomy for Siewert types II and III adenocarcinoma of the esophagogastric junction

Xiao, Jiangwei; Liu, Zilin; Ye, Peng-Cheng; Luo, Yang; Fu, Zhiming; Zou, Qin; Wei, Shoujiang

doi:10.3748/wjg.v21.i34.9999

Cited by 26 publications

(26 citation statements)

References 32 publications

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“…According to the Japanese gastric cancer guidelines, total gastrectomy with D2 lymphadenectomy is the standard option for advanced gastric cancers [ 5 ]. It was reported that 60% to 70% of proximal gastric cancers are treated with chemotherapy after proximal gastrectomy with esophago-gastrostomy and antrum-preserving signal tract reconstruction [ 14 ]. In this study, some patients in both groups underwent proximal gastrectomy and esophagogastrostomy.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of laparoscopic gastrectomy for patients with Siewert-type II/III adenocarcinoma of the esophagogastric junction: A propensity score matching analysis

Shi

Xiao

et al. 2018

PLoS ONE

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Background/AimThe feasibility of using laparoscopic gastrectomy for the treatment of Siewert-type II/III adenocarcinoma of the esophagogastric junction (AEG) has not been addressed. This study aimed to comparatively evaluate the short- and long-term effects on laparoscopic versus open surgery using (propensity score matching) PSM for Siewert-type II/III AEG.MethodsWe retrospectively collected data from the patients with Siewert-type II/III AEG who were treated in our cancer center between January 2013 and December 2015. Patients undergoing laparoscopic gastrectomy and open gastrectomy were matched via PSM. The cumulative 2-year Overall survival (OS) rate of patients in the two cohorts was estimated by Kaplan-Meier plots. Multi-variable analysis using a Cox regression model was conducted to identify independent risk factors.ResultsA total of 963 patients with Siewert-type II/III AEG were included, of which 132 cases were in the laparoscopic gastrectomy group, and 831 cases were in the open gastrectomy group. After regrouping with PSM, 132 patients in the laparoscopic gastrectomy group were balanced with 264 similar patients in the open gastrectomy group. As expected, the laparoscopic gastrectomy group had significantly longer operation times, but less blood loss. Furthermore, the two groups showed similar results for post-operative complications, duration of hospital stay and 2-year OS rate. Combined organ resection was an independent risk factor for 2-year OS rate.ConclusionThis study suggests that laparoscopic gastrectomy may serve as a safe and feasible treatment for Siewert-type II/III AEG and achieve similar oncologic outcomes as open gastrectomy.

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Section: Discussionmentioning

confidence: 99%

Feasibility of laparoscopic gastrectomy for patients with Siewert-type II/III adenocarcinoma of the esophagogastric junction: A propensity score matching analysis

Shi

Xiao

et al. 2018

PLoS ONE

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“…Many reconstruction methods are meant to resist reflux, while it remains lacking consensus. A retrospective study demonstrated that double tract reconstruction is a simple and effective method in decreasing reflux esophagitis compared with Roux-en-Y [29] . It still needs RCT to provide high-grade evidence for the method.…”

Section: Reconstruction Methods For Siewert Type II Aegmentioning

confidence: 99%

Siewert type II adenocarcinoma of esophagogastric junction: treatment status

Li¹,

Zang²

2019

MIS

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The incidence of adenocarcinoma of esophagogastric junction (AEG) has been increased continuously in the past decades, especially in western countries. Siewert type II is regard as the true AEG because of its location, however, the treatment for Siewert type II AEG has not reached a consensus in the academic. According to published studies nowadays, this commentary will introduce the surgical strategies and put forward suggestions for Siewert type II AEG in several aspects as follows: (1) optimal surgical approach; (2) optimal extent of lymph node dissection; (3) reconstruction methods. With the development of minimally invasive surgery, many experienced surgeons perform esophagogastrostomy via transhiatal approach. Moreover, many details during the surgery still need further research by cooperation between different departments and even countries.

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“…In the case of early EGJ lesions, surgical treatment must not be tailored only based on the oncologic outcome, but it must also aid the preservation of the digestive function as much as possible. Several authors published their favorable functional results on proximal gastrectomy and double tract jejunal reconstruction [26,27].…”

Section: Early Egj Lesionsmentioning

confidence: 99%

A Surgeon’s Role in the Management of Early Esophageal, EGJ and Gastric Lesions

Simić

Skrobić

Peško

2019

Dig Dis

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Background: Endoscopic mucosal resection and submucosal dissection (ESD) are indicated in a majority of mucosal esophageal, esophagogastric junction and gastric cancers (GC), and selected cases of submucosal cancers as well. Summary: The presence of lymph node metastases in early esophageal cancer (EC) has been proven in up to 50% of patients with sm3 cancers treated with surgical resection, and up to 18.5 and 30.5% in sm1 and sm2 cancer respectively. The presence of lymphovascular invasion (LVI), tumor depth >500 μm and poor tumor differentiation seem to be a common predictor of worse outcomes in literature reports. In case of early esophagogastric junction cancer (EGJC) these predictors include LVI, tumor size >3 cm, Barrett’s origin of the tumor and ulcerative tumor appearance. Extended indications for ESD in early GC are already adopted in high volume centers with high success rates (up to 98%). Jet, positive resection margins after ESD, LVI and poor tumor differentiation carry high metastatic potential, therefore advocating surgery. Limited resections and cooperative laparoscopic endoscopic approach may be implemented in cases of early EGJC and GC. Key Messages: The presence of LVI, depth of submucosal invasion, and poor tumor differentiation in cases of early EC, EGJC, and GC favor surgical treatment despite improvements in endoscopic techniques.

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Clinical comparison of antrum-preserving double tract reconstructionvsroux-en-Y reconstruction after gastrectomy for Siewert types II and III adenocarcinoma of the esophagogastric junction

Cited by 26 publications

References 32 publications

Feasibility of laparoscopic gastrectomy for patients with Siewert-type II/III adenocarcinoma of the esophagogastric junction: A propensity score matching analysis

Feasibility of laparoscopic gastrectomy for patients with Siewert-type II/III adenocarcinoma of the esophagogastric junction: A propensity score matching analysis

Siewert type II adenocarcinoma of esophagogastric junction: treatment status

A Surgeon’s Role in the Management of Early Esophageal, EGJ and Gastric Lesions

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