Safety and short‑term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy: a propensity score matching analysis
Abstract Objective To 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...
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BMC
2025-05-01
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| Online Access: | https://doi.org/10.1186/s12885-025-14284-9 |
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| author | Chaoyang Zhang Kaixing Wang Zhidong Zhang Xuefeng Zhao Bin Yao Weishuai Zhang |
| author_facet | Chaoyang Zhang Kaixing Wang Zhidong Zhang Xuefeng Zhao Bin Yao Weishuai Zhang |
| author_sort | Chaoyang Zhang |
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| description | Abstract Objective To 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. Methods The 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). Results The 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). Conclusion mTEG 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. |
| format | Article |
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| institution | DOAJ |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj-art-5773a9696b1d468593f4211aa0a4e89a2025-08-20T03:08:25ZengBMCBMC Cancer1471-24072025-05-0125111110.1186/s12885-025-14284-9Safety and short‑term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy: a propensity score matching analysisChaoyang Zhang0Kaixing Wang1Zhidong Zhang2Xuefeng Zhao3Bin Yao4Weishuai Zhang5The Third Department of Surgery, The Fourth Hospital of Hebei Medical UniversityThe Third Department of Surgery, The Fourth Hospital of Hebei Medical UniversityThe Third Department of Surgery, The Fourth Hospital of Hebei Medical UniversityThe Third Department of Surgery, The Fourth Hospital of Hebei Medical UniversityThe Third Department of Surgery, The Fourth Hospital of Hebei Medical UniversityThe Third Department of Surgery, The Fourth Hospital of Hebei Medical UniversityAbstract Objective To 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. Methods The 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). Results The 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). Conclusion mTEG 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.https://doi.org/10.1186/s12885-025-14284-9Proximal gastrectomyTubular reconstructionDouble tract reconstructionQuality of life |
| spellingShingle | Chaoyang Zhang Kaixing Wang Zhidong Zhang Xuefeng Zhao Bin Yao Weishuai Zhang Safety and short‑term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy: a propensity score matching analysis BMC Cancer Proximal gastrectomy Tubular reconstruction Double tract reconstruction Quality of life |
| title | Safety and short‑term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy: a propensity score matching analysis |
| title_full | Safety and short‑term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy: a propensity score matching analysis |
| title_fullStr | Safety and short‑term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy: a propensity score matching analysis |
| title_full_unstemmed | Safety and short‑term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy: a propensity score matching analysis |
| title_short | Safety and short‑term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy: a propensity score matching analysis |
| title_sort | safety and short term outcomes of a modified tubular esophagogastrostomy versus double tract reconstruction after proximal gastrectomy a propensity score matching analysis |
| topic | Proximal gastrectomy Tubular reconstruction Double tract reconstruction Quality of life |
| url | https://doi.org/10.1186/s12885-025-14284-9 |
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