Comparison of the efficacy between LAPG and LATG in the treatment of Siewert Ⅱ and Ⅲ AEG

ObjectiveTo compare the clinical efficacy between laparoscopic-assisted total gastrectomy(LATG) and laparoscopic-assisted proximal gastrectomy(LAPG) in the treatment of Siewert Ⅱ and Ⅲ esophagogastric adenocarcinoma(AEG).

MethodsThe clinical data of 62 patients with type Ⅱ and type Ⅲ AEG were retrospectively analyzed.Thirty-two cases treated with LAPG and 30 cases treated with LATG were divided into the LAPG group and LATG group, respectively.The operation time, number of lymph nodes dissected, blood loss during operation, recovery time of gastrointestinal function, postoperative hospital stay, perioperative and postoperative complications were compared between two groups.The survival, quality of life and CEA situation in two groups were recorded.

ResultsThe differences of the intraoperative bleeding volume, TNM staging, recent complications and level of serum CEA after 12 months of operation between two groups were not statistically significant(P>0.05).The number of lymph nodes in LATG group(22.9±6.7) was more than that in LAPG group(19.7±4.6)(P < 0.01), the operation time in LATG group was significant longer than that in LAPG group(P < 0.01), and the incidence rate of reflux esophagitis in LAPG group(40.0%) was more than that in LAPG group(3%)(P < 0.05).

ConclusionsThe LAPG and LATG in treating Siewert type Ⅱ and Ⅲ AEG are safety.The lymph node dissection of LATG is more, and the long-term complications of LATG is fewer.The progressive phase AGE should be treated with LATG.