Proximal gastrectomy and gastric tube reconstruction for early cancer of the gastric cardia

Background: Advances in diagnostics and techniques have increased the numbe r of detections of early cancer of the gastric cardia. The aim of this repo rt is to describe a new technique of proximal gastrectomy and gastric tube reconstruction using an autosuture stapler. Methods: At operation, the uppe r part of the stomach was fully mobilized, and the abdominal esophagus was transected. The stomach was cut between the points of the distal three four ths of the lesser curvature and a half of the greater curvature, and a gast ric tube measuring 20 cm in length and 4 cm in width was made. A circular s tapler was inserted through a stapled line, and direct anastomosis between the esophagus and gastric tube was completed. Results: When compared with t he patients who underwent proximal gastrectomy and jejunal interposition, t hose who underwent gastric tube reconstruction showed a significantly short er operation time. All 3 patients who underwent proximal gastrectomy and ga stric tube reconstruction recovered uneventfully and took foods satisfactor ily. Good passage through the gastric tube was recognized on roentgenograph y, and reflux esophagitis or stomal ulcer was not found on fiberscopy. Conc lusions: We believe the procedure is technically simple and safe, and provi des good postoperative results in patients with early cancer of the gastric cardia. Copyright (C) 1999 S. Karger AG, Basel.