[Application of jejunal interposition after radical proximal gastrectomy]

Area of Science:

• Surgical oncology
• Gastrointestinal surgery
• Oncology

Context:

• Radical proximal gastrectomy for gastric cancer necessitates effective digestive tract reconstruction.
• Evaluating surgical techniques is crucial for patient outcomes and adjuvant therapy tolerance.
• Adjuvant chemotherapy regimens like mFOLFOX-6 are standard but can be limited by patient tolerance.

Purpose:

• To compare jejunal interposition with gastroesophagostomy for digestive tract reconstruction after proximal gastrectomy.
• To assess the impact of reconstruction methods on postoperative complications, reflux esophagitis, nutritional status, and tolerance to mFOLFOX-6 chemotherapy.

Summary:

• Jejunal interposition resulted in longer operation times but significantly reduced reflux esophagitis and improved nutritional status at 3 and 6 months post-surgery.
• Patients undergoing jejunal interposition demonstrated significantly higher completion rates for adjuvant mFOLFOX-6 chemotherapy (94.7%) compared to the gastroesophagostomy group (50.0%).
• No significant differences were observed in immediate postoperative inflammatory markers or overall operation risk between the two groups.

Impact:

• Jejunal interposition is a viable and beneficial method for digestive tract reconstruction following radical proximal gastrectomy.
• Improved tolerance to adjuvant chemotherapy can lead to more effective cancer treatment and better patient survival rates.
• Enhanced quality of life and reduced reflux symptoms contribute to improved long-term patient well-being.