PROXIMAL GASTRECTOMY AND JEJUNAL POUCH INTERPOSITION FOR THE TREATMENT OF EARLY CANCER IN THE UPPER 3RD OF THE STOMACH - SURGICAL TECHNIQUES AND EVALUATION OF POSTOPERATIVE FUNCTION

Background. Limited surgery for the treatment of early gastric cancer located in the upper third of the stomach should be based on a well-ba lanced reduction in the extent of lymph node dissection and gastric re section while assuring a favorable quality of life and prognosis after operation. Methods, We have used interposition of a double jejunal po uch between the esophagus and the remnant stomach after performing pro ximal gastrectomy. To assure anastomosis and hemostasis during this op eration we currently use a surgical stapler with a vaginoscope and our new edge clamps. This method has been used in 12 patients to date. Re sults, On histopathologic examination the 12 cases comprised 11 early cancers (seven mucosal and four sub-mucosal cancers) and one subserosa l cancer There was no evidence of lymph node metastasis or postoperati ve complications such as anastomotic leakages or hemorrhage, demonstra ting the low-risk nature of this procedure. Conclusions. The evaluatio n of postoperative quality of life, in terms of clinical signs and sym ptoms and dietary status, yielded favorable results. Thus our method h as the important advantage of allowing good organ preservation.