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laparoscopic-assisted vs open transhiatal gastrectomy for Siewert type Ⅱ adenocarcinoma of the esophagogastric junction: A retrospective cohort study

引用

World Journal of Gastrointestinal Surgery 2022年第4期14卷 304-314页

作者： Qi-Ying Song Xiong-Guang Li Li-Yu Zhang Di Wu Shuo Li Ben-Long Zhang Zi-Yao Xu Ri-Li-Ge Wu Xin Guo Xin-Xin Wang Medical School of Chinese People’s Liberation Army Chinese People’s Liberation Army General HospitalBeijing 100853China School of Medicine Nankai UniversityTianjin 300071China Medical Big Data Research Center Chinese PLA General HospitalBeijing 100853China Air Force Medical University Xijing Hospital Xi’an 710000Shaanxi ProvinceChina Department of General Surgery Chinese People’s Liberation Army General HospitalBeijing 100853China

BACKGROUND The studies of laparoscopic-assisted transhiatal gastrectomy(LTG) in patients with Siewert type Ⅱ adenocarcinoma of the esophagogastric junction(AEG) are *** To compare the surgical efficiency of LTG with the open transhiatal gastrectomy(OTG) for patients with Siewert type Ⅱ *** We retrospectively evaluated a total of 578 patients with Siewert type Ⅱ AEG who have undergone LTG or OTG at the First Medical Center of the Chinese People’s Liberation Army General Hospital from January 2014 to December 2019. The short-term and long-term outcomes were compared between the LTG(n = 382) and OTG(n = 196) *** Compared with the OTG group, the LTG group had a longer operative time but less blood loss, shorter length of abdominal incision and an increased number of harvested lymph nodes(P < 0.05). Patients in the LTG group were able to eat liquid food, ambulate, expel flatus and discharge sooner than the OTG group(P < 0.05). No significant differences were found in postoperative complications and R0 resection. The 3-year overall survival and disease-free survival performed better in the LTG group compared with that in the OTG group(88.2% vs 79.2%, P = 0.011;79.7% vs 73.0%, P = 0.002, respectively). In the stratified analysis, both overall survival and disease-free survival were better in the LTG group than those in the OTG group for stage Ⅱ/Ⅲ patients(P < 0.05) but not for stage I *** For patients with Siewert type Ⅱ AEG, LTG is associated with better short-term outcomes and similar oncology safety. In addition, patients with advanced stage AEG may benefit more from LTG in the long-term outcomes.

关键词： Adenocarcinoma of the esophagogastric junction Siewert type II laparoscopic-assisted transhiatal gastrectomy Open transhiatal gastrectomy

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