J Korean Gastric Cancer Assoc.  2009 Dec;9(4):207-214.

A Comparison of Segmental Gastrectomy and Distal Gastrectomy with Billroth I Reconstruction for Early Gastric Cancer That's Developed on the Gastric Body

Affiliations
  • 1Department of Surgery, Chungnam National University School of Medicine, Daejeon, Korea. seungnoh@cnu.ac.kr

Abstract

PURPOSE
Subtotal distal gastrectomy has been accepted as the standard treatment for early gastric cancer that's developed on the gastric body. EMR and ESD have been introduced to minimize the incidence of postgastrectomy syndrome, but these procedures can not detect lymph node metastasis and they have a risk for gastric perforation. Segmental gastrectomy has recently been applied for treating early gastric cancer, but its usefulness has not been clarified. The aim of this study was to compare segmental gastrectomy and distal gastrectomy with Billroth I reconstruction for treating early gastric cancer that's developed on the gastric body.
MATERIALS AND METHODS
We performed a retrospective review of all the patients who were diagnosed as having early gastric cancer that developed on the gastric body at Chungnam National University Hospital from January 2004 through July 2007. During this period, 41 patients received segmental gastrectomy and 40 patients underwent subtotal distal gastrectomy. All the patients were studied via a biannual review of the body systems, a physical examination, endoscopy, computed tomography and the laboratory findings.
RESULTS
There were no significantly differences of the clinicopathologic characteristics between the two groups. The changes of the nutritional status (Hb, TP, Alb and TC) and the body weight change were not significantly different between the 2 groups. There were significantly more residual food in the SG group than that in the SDG group (RGB classification, Residual>Grade 2), but there were no differences for epigastric discomfort (P>0.05). Esophagitis developed at a similar rate for both two groups (LA classification, >Grade A), and bile reflux was found in only one patient of each group.
CONCLUSION
We expected the reduction of esophagitis and gastritis and the improvement of nutritional status according to the type of procedure. Yet the results of our study showed no significant differences between the two study groups. More patients and a longer follow up time are needed for determining the advantage sand disadvantages of segmental gastrectomy.

Keyword

Early gastric cancer; Central gastrectomy; Segmental gastrectomy; Gastric body

MeSH Terms

Bile Reflux
Body Weight Changes
Endoscopy
Esophagitis
Gastrectomy
Gastritis
Gastroenterostomy
Humans
Imidazoles
Incidence
Lymph Nodes
Neoplasm Metastasis
Nitro Compounds
Nutritional Status
Physical Examination
Postgastrectomy Syndromes
Retrospective Studies
Silicon Dioxide
Stomach Neoplasms
Imidazoles
Nitro Compounds
Silicon Dioxide
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