Double-tract vs gastric tube reconstruction after proximal gastrectomy in upper third gastric cancer: a Propensity Score Matching Analysis

Abstract Background With the popularity of function-preserving gastrectomy(FPG) and minimally invasive surgery, proximal gastrectomy(PG) has been widely used in the upper third gastric cancer. There are many reconstruction methods after PG, but the optimal one is still uncertain. The aim of this study is to compare the short-term and long-term outcomes of double-tract reconstruction(DT) and gastric tube reconstruction(Tube) after proximal gastrectomy. Methods This study retrospectively reviewed patients who underwent gastrectomy from January 2010 to January 2022 in our hospital. According to the reconstruction method after PG, patients were divided into DT group and Tube group. After adjusting for propensity score matching analysis, we compared the surgical outcomes, complications, and postoperative long-term reflux esophagitis and nutritional status between the two groups. Result After propensity score matching had been done, a total of 44 patients were included in this analysis (22 patients in the Tube and DT groups respectively). There were no significance between the two groups in postoperative complications, days of postoperative hospital stay, hemoglobin and albumin decreasing rate at 6 months, and weight loss at 6 and 12 months. The operation time of Tube group was shorter (230 vs 290 min, p = 0.005). The visick score (p = 0.012) and the rate of endoscopic reflux esophagitis (p = 0.001) of DT group were significantly lower . Conclusion There is no significance in postoperative complications and nutritional status between double-tract and gastric tube reconstruction after PG. Tube reconstruction can greatly reduce the operation time, while double-tract is more effective in preventing postoperative esophageal reflux.