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QUALITY OF LIFE AFTER GASTRECTOMY OPERATED BY DIFFERENT METHODS: COMPARATIVE STUDY

Aleksei Spartak

Abstract

Cancer of the esophageal-gastric junction is on the 6th place in the world in the structure of mortality from cancer. Russia is one of the regions with a high incidence of gastric cancer and mortality from this disease. Due to the borderline location of the tumor between the esophagus and the stomach, the world does not accept a single surgical treatment of gastroesophageal junction cancer. The classification of this cancer is discussed also. Esophagogastrostomy is the simplest method of reconstruction after proximal resection of the stomach but is associated with a high risk of reflux esophagitis and stricture anastomosis in the postoperative period, which can significantly worsen the quality of life in these patients. In comparative studies reported that the detection rate of symptoms of reflux esophagitis did not differ between the group of patients with esophagogastrostomy and a group of patients with the interposition of segment of small intestine (Yasuda A. et al., 2014; T. Masuzawa et al., 2014; Tokunaga M. et al., 2009), between the group of patients with esophagogastrostomy and a group of patients operated by the method of double tract , between the group of patients with interposition of a segment of the small intestine and the group of patients with small bowel reservoir formed or between the group of patients with the interposition of segment of the small intestine and the group of patients operated by the method of double tract . Ruchkin D. V. and employees of the A.V. Vishnevsky Institute of surgery conducted a scientific study proving the technical simplicity of Jejunogastroplasty as a primary method of reconstruction of the digestive tract after gastrectomy, low frequency of associated complications and good quality of life of patients in the long term (Ruchkin, D. V. et al., 2014). Currently, there is a need to standardize the surgical technique for cancer of the esophageal-gastric junction, to improve both close and long-term results of treatment of these patients. Moreover, although the formation of esophagogastrostomy is the simplest method of reconstruction after proximal gastrectomy, the incidence of reflux-esophagitis in postoperative period was higher in comparison with other reconstructive techniques. Thus, we have considered the immediate and long-term results of proximal gastric resection performed for gastric cancer, and we have not found significant differences in the frequency of complications such as failure and anastomosis stricture between the described reconstructive techniques. The number of anastomoses did not significantly affect the frequency of complications.

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DOI resolver: doi.org/10.5593/sgemsocial2018/3.3/S12.077

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