Abstract：Objective To investigate the clinical efficacy and postoperative survival in esophagogastric junction / cardiac cancer patients undergoing different types of radical gastrectomy and reconstruction.Methods clinical records of 89 patients with esophagogastric junction / cardiac cancer undergoing radical gastrectomy between October 2004 and May 2013 were analyzed. Of these patients, 26 cases underwent proximal gastrectomy with esophageal-residual stomach anastomosis (Group A), 42 underwent total gastrectomy with esophagojejunal Roux-en-Y anastomosis (Group B), and 21 underwent proximal gastrectomy with restrictive dual channel between folding jejunum reconstruction (Xijing Operation Group). Surgery-related parameters, postoperative complications, nutritional status and survival rat were compared between the three groups. Results The operative time and intraoperative blood loss in Group A were significantly decreased compared with the other two groups.The number of lymph nodes dissected was larger but the nutritional indexes were worse in Group B than in the other two groups (all P<0.05). There was no statistically significant difference in the incidence of overall postoperative complications between the three groups, but the incidence of dumping syndrome in Group B was significantly higher than in the other two groups (all P<0.05). There was no significant difference in 1、3 and 5 year survival rates between the three groups (χ2=0.440,P=0.803;χ2=0.234,P=0.890;χ2=0.045,P=0.978). Conclusions The three surgical procedures can lead to a similar postoperative survival rate for esophagogastric junction / cardiac cancer. Proximal gastrectomy plus esophageal-residual stomach anastomosis is less traumaticwhile proximal gastrectomy with restrictive dual channel between folding jejunum reconstruction allows better quality of life, so the selection of procedures should be based on the surgical skills of physicians and the actual clinical conditions of the patient.
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2016, Vol. 27 
