[Clinical outcomes of surgical patients with types II and III adenocarcinoma of esophagogastric junction].

OBJECTIVE

To investigate the clinical pathological characteristics, choice of surgical therapy and postoprative complications of patients with types II and III adenocarcinoma of esophagogastric junction (AEG).

METHODS

Clinical data of 112 patients with types II and III AEG who underwent intraperiteanal operations from January 2008 to July 2010 were reviewed. Amongst the patients, 77 suffered from type II AEG and 35 suffered from type III AEG; 72 underwent proximal gastrectomy and 40 underwent total gastrectomy.

RESULTS

The patients with type II and type III AEG shared some common characteristics, such as advanced tumor TNM stage and lymphatic metastasis. There was a significant difference in choice of surgical approaches between the two groups of patients (P < 0.05), with 57 type II AEG patients (74.0%) and 15 type III AEG patients (42.9%) undergoing proximal gastrectomy respectively. Operational time and incidence of postoperative complications differed between proximal gastrectomy and total gastrectomy (P < 0.05). Total gastrectomy lasted longer [(304.12 +/- 23.12) min] than proximal gastrectomy [(275.76 +/- 27.02) min]. Proximal gastrectomy provoked 20.8% (15 patients) heartburn and/or acid regurgitation and 12.5% (9 cases) reflux esophagitis. Fifteen patients (37.5%) with total gastrectomy had more than 5 meals a day.

CONCLUSION

Intraperiteanal operations are recommended for patients with types IT and Ili AEG. The choice of proximal gastrectomy or total gastrectomy depends on the location and size of the tumor, both being followed with some complications.