Background: Advances in diagnostics and techniques have increased the number of detections of early cancer of the gastric cardia. The aim of this report is to describe a new technique of proximal gastrectomy and gastric tube reconstruction using an autosuture stapler. Methods: At operation, the upper part of the stomach was fully mobilized, and the abdominal esophagus was transected. The stomach was cut between the points of the distal three fourths of the lesser curvature and a half of the greater curvature, and a gastric tube measuring 20 cm in length and 4 cm in width was made. A circular stapler was inserted through a stapled line, and direct anastomosis between the esophagus and gastric tube was completed. Results: When compared with the patients who underwent proximal gastrectomy and jejunal interposition, those who underwent gastric tube reconstruction showed a significantly shorter operation time. All 3 patients who underwent proximal gastrectomy and gastric tube reconstruction recovered uneventfully and took foods satisfactorily. Good passage through the gastric tube was recognized on roentgenography, and reflux esophagitis or stomal ulcer was not found on fiberscopy. Conclusions: We believe the procedure is technically simple and safe, and provides good postoperative results in patients with early cancer of the gastric cardia.

Keywords:
Proximal gastrectomy, Gastric tube, Early gastric cancer, Gastric cardia
1.
Adachi Y, Mimori K, Mori M, Maehara Y, Sugimachi K: Morbidity after D2 and D3 gastrectomy for node-positive gastric carcinoma. J Am Coll Surg 1997;184:240–244.
2.
Korenaga D, Orita H, Okuyama T, Moriguchi S, Maehara Y, Sugimachi K: Quality of life after gastrectomy in patients with carcinoma of the stomach. Br J Surg 1992;79:248–250.
3.
Mori M, Kitagawa S, Iida M, Sakurai T, Enjoji M, Sugimachi K, Oiwa T: Early carcinoma of the gastric cardia: A clinicopathologic study of 21 cases. Cancer 1987;59:1758–1766.
4.
Adachi Y, Mori M, Maehara Y, Kitano S, Sugimachi K: Prognostic factors of node-negative gastric carcinoma: Univariate and multivariate analyses. J Am Coll Surg 1997;184:373–377.
5.
Matsukuma A, Furusawa M, Tomoda H, Seo Y: A clinicopathological study of asymptomatic gastric cancer. Br J Cancer 1996;74:1647–1650.
6.
Kameyama J, Ishida H, Yasaku Y, Suzuki A, Kuzu H, Tsukamoto M: Proximal gastrectomy reconstructed by interposition of a jejunal pouch: Surgical technique. Eur J Surg 1993;159:491–493.
7.
Takeshita K, Saito N, Saeki I, Honda T, Tani M, Kando F, Endo M: Proximal gastrectomy and jejunal pouch interposition for the treatment of early cancer in the upper third of the stomach: Surgical techniques and evaluation of postoperative function. Surgery 1997;121:278–286.
8.
Sugimachi K, Ohno S, Maekawa S, Mori M, Kuwano H, Ueo H: Safety of EEA staplers for anastomosis between upper esophagus and the gastric tube. J Surg Oncol 1990;43:40–44.
9.
Kitano S, Iso Y, Moriyama M, Sugimachi K: Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 1994;4:146–148.
10.
Adachi Y, Inomata M, Kitano S, Mori M, Maehara S, Sugimachi K: Dukes’ A tumor: New criteria for early gastric cancer. Oncol Rep 1997;4:1235–1237.
11.
Kitamura K, Yamaguchi T, Nishida S, Yamamoto K, Ichikawa D, Okomoto K, Taniguchi H, Hagiwara A, Sawai K, Takahashi T: The operative indications for proximal gastrectomy in patients with gastric cancer in the upper third of the stomach. Jpn J Surg 1997;27:993–998.
© 1999 S. Karger AG, Basel
2000
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