Lower esophageal sphincter- and vagus-preserving proximal partial gastrectomy for early cancer of the gastric cardia.

Abstract:

PURPOSE:Proximal gastrectomy and lymph node dissection are often performed for T1 cancer of the gastric cardia; however, direct esophagogastrostomy is frequently complicated by reflux esophagitis. We describe a simple technique for preventing esophageal reflux and discuss its results. METHODS:This technique is indicated for T1 cancer of the gastric cardia without lymphadenopathy. Partial resection, including the lesion, is performed, preserving the vagus nerve and lower esophageal sphincter (LES). Lymph node dissection is done around the left gastric, celiac, and splenic arteries. The esophagus is then anastomosed to the anterior wall in the center of the remnant stomach. RESULTS:We evaluated the results of this procedure in eight patients. X-ray films showed no esophageal reflux in either the supine or the right decubitus position. None of the patients complained of reflux or other dyscrasic symptoms, and none had any feeling of microgastria. One patient had some localized erosion near the anastomosis. CONCLUSIONS:This simple and safe technique does not result in post-gastrectomy syndrome or microgastria, and the risk of leaving cancer cells is minimal.

journal_name

Surg Today

journal_title

Surgery today

authors

Hirai T,Matsumoto H,Iki K,Hirabayashi Y,Kawabe Y,Ikeda M,Yamamura M,Hato S,Urakami A,Yamashita K,Tsunoda T,Haruma K

doi

10.1007/s00595-006-3265-y

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

874-8

issue

10

eissn

0941-1291

issn

1436-2813

journal_volume

36

pub_type

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