Comparison Of Total Gastrectomy And Proximal Gastrectomy In The Treatment Of Upper Gastric Cancer

Objective: To compare the clinical effects of proximal gastrectomy and total gastrectomy in the treatment of upper gastric cancer,and to provide a reasonable reference for the treatment of upper gastric cancer in the future.Methods: A retrospective study was conducted to collect the clinical data of the patients for treatment who were admitted to the general surgery of our hospital from January 2014 to December 2017.A total of 69 patients were divided according to the difference of operation methods.The laparoscopic assisted proximal gastrectomy(LAPG)group included 38 cases and the laparoscopic assisted total gastrectomy(LATG)group included 21 cases.The age,gender,body mass index(BMI),ASA score,operation time,postoperative exhaust time,postoperative nutritional risk at 3 months(hemoglobin and albumin levels),3-year tumor recurrence rate and 3-year survival rate were analyzed to compare the clinical outcomes of the two groups of patients.Results:1.There was no statistical difference in age,gender,BMI,ASA score between the two groups(P>0.05).2.There was a statistical difference in the operation time and postoperative exhaust time of the two groups(P<0.05).3.There was no statistical difference in the incidence of early complications between the two groups(P>0.05).4.The nutritional risk of LAPG group was lower than that of LATG group at 3 months after operation,and the difference was statistically significant(P<0.05).5.The incidence rate of long-term complications in the LAPG group was higher than that in LATG group(P<0.05).6.The 3-year recurrence rate of LAPG group was higher than that of LATG group,and the 3-year survival rate was lower than that of LATG group,but the difference was not statistically significant(P > 0.05).Conclusions: Proximal gastrectomy for upper gastric cancer can shorten the operation time and reduce the intraoperative blood loss.The hemoglobin and albumin levels remain high at the short term after operation.Total gastrectomy can reduce the time needed for postoperative exhaust,be beneficial to the detection of postoperative lymph nodes,reduce the incidence rate of postoperative long-term complications,improve the quality of life,reduce the recurrence rate and prolong the survival time of patients.Therefore,the choice of proximal gastrectomy or total gastrectomy for upper gastric cancer should be based on individual analysis.