Safety and Feasibility of Proximal Gastrectomy and Total Gastrectomy for Advanced Siewert Type Ⅱ and Ⅲ Esophagogastric Unction Adenocarcinoma

WU Longxiang; XIA Xiaochun; XUE Qiu

doi:10.14033/j.cnki.cfmr.2025.22.002

Abstract：Objective:To compare the efficacy of proximal gastrectomy and total gastrectomy in the treatment of advanced Siewert typeⅡ and Ⅲ adenocarcinoma of the esophagogastric junction.Method:A retrospective analysis was conducted on the clinical data of 80 patients with esophagogastric junction adenocarcinoma who received treatment in the hospital from March 2022 to April 2024.Among them,40 patients underwent proximal gastrectomy,and 40 patients underwent total gastrectomy.The surgical-related indicators,postoperative related indicators and the incidence of postoperative complications between the two groups were compared.Result:The operation time and incision length in the total gastrectomy group were longer than those in the proximal gastrectomy group,P<0.05.There was no statistically significant difference in intraoperative blood loss between the total gastrectomy group and the proximal gastrectomy group(P>0.05).There was no statistically significant difference in the catheterization time and hospital stay between the two groups(P>0.05).The gastric tube drainage volume in the total gastrectomy group was less than that in the proximal gastrectomy group 1 to 3 days after operation,P<0.05.There was no statistically significant difference in postoperative complications such as reflux esophagitis and intestinal obstruction between the two groups(P>0.05).Conclusion:Proximal gastrectomy is superior to total gastrectomy in surgical time,incision length and postoperative drainage volume.There is no difference in complications between total gastrectomy and proximal gastrectomy,and total gastrectomy is more effective for patients with advanced Siewert typeⅡ and Ⅲ esophagogastric junction adenocarcinoma.