ArticleBMC cancer2025
Safety and short‑term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy: a propensity score matching analysis.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo comparatively evaluate the short-term clinical efficacy and quality of life (QoL) between modified tubular esophagogastrostomy (mTEG) and double tract reconstruction (DTR) following proximal gastrectomy (PG), aiming to establish evidence-based recommendations for reconstruction method selection.
methodsThe mTEG technique involved three essential steps: 1) tubular reconstruction of gastric remnant, 2) 3-cm artificial gastric fornix creation, and 3) His angle sharpening with posterior mediastinal fixation. This retrospective study included 288 PG patients (2021-2024). Propensity score matching (1:1, caliper = 0.03) balanced baseline characteristics, and thirty-three matched pairs were analyzed. Outcomes encompassed operative metrics, postoperative complications (Clavien-Dindo ≥ II), nutritional status (prealbumin, albumin, hemoglobin, BMI at 1/3/6 months), and QoL (EORTC QLQ-STO22 at 6 months).
resultsThe mTEG group demonstrated shorter median operative time (163.7 vs 247.9 min, p < 0.001) and postoperative hospitalization (8.3 vs 9.9 days, p = 0.001). Intraoperative outcomes including blood loss and lymph node yield were comparable. Early complications (≤ 30 days) occurred exclusively in the DTR group (4 cases: 2 anastomotic leakage, 1chylous leakage and 1 pulmonary related). complication rates showed no statistical difference (p > 0.05). Endoscopic findings demonstrated comparable incidence of reflux esophagitis in Los Angeles Grade B or higher (11.1% vs 4.5%, p = 0.457). Nutritional parameters and QoL scores remained equivalent between groups at all timepoints (p > 0.05).
conclusionmTEG represents a technically optimized reconstruction method that achieves equivalent nutritional preservation and reflux prevention compared to DTR, while offering distinct advantages in surgical efficiency and postoperative recovery. These findings support mTEG as a viable reconstruction option for PG patients.
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