• Yasumasa Kondoh, Akiko Ishii, Kazuhiro Ishizu, Tomoko Hanashi, Yuichi Okamoto, Mari Morita, Kazuhito Nabeshima, Kenji Nakamura, Jinichi Soeda, Kyoji Ogoshi, and Hiroyasu Makuuchi.
• Department of Surgery, Tokai University Tokyo Hospital, 1-2-5, Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan. ykondoh@tok.u-tokai.ac.jp
• Tokai J. Exp. Clin. Med. 2006 Dec 20; 31 (4): 146-9.

ObjectiveThis study was designed to assess the outcome of esophagogastrostomy before proximal gastrectomy in patients with early gastric cancers in the upper third of the stomach.MethodsFrom 1997 through 2004, we studied 10 consecutive patients. A stapler was introduced into the stomach, and an esophagogastrostomy was performed before proximal gastrectomy. Hill's posterior gastropexy and Dor's anterior fundic wrap were performed to prevent reflux esophagitis.ResultsThe operation time was 171 ± 44 minutes, and the intraoperative bleeding volume was 294 ± 228 mL. There was no anastomotic leakage. Anastomotic stenosis, occurring in 40% of the patients, required endoscopic balloon dilatation. Symptoms of reflux esophagitis, occurring in 40% of the patients, resolved within 2 years after operation. As compared with the preoperative value, body mass index was significantly decreased 1 and 2 years after operation, but was similar at 3 to 5 years. The percent decrease in body weight after operation fluctuated between 6% and 8% between 2 and 5 years. Postoperative weight loss was thus mild.ConclusionsEsophagogastrostomy before proximal gastrectomy may be less invasive, simpler, and produce better outcomes than conventional procedures for the surgical treatment of early gastric cancer in the upper third of the stomach.

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