The Risk Factors of Reflux Complication after Gastrectomy for Proximal Gastric Cancer

Purpose: The aim of this study was to investigate the risk factors of reflux associated complications (reflux symptoms, reflux esophagitis, and esophageal stricture) after gastrectomy for proximal gastric cancer. Methods: 150 patients with proximal gastric cancer were included from January 2005 to December 2008. Their medical and surgical records were retrospectively analyzed concerning clinical and pathologic characteristics, operation methods, morbidity, reflux associated complications and nutritional states. Results: Tumor sizes and operation methods were statistically significant in univariate analysis of risk factors for reflux associated complications (P<0.05). However, only operation methods were statistically significant in multivariate analysis (P=0.00). We, thus, compared operation methods. There were no significant differences in morbidity, body weight, hemoglobin, serum cholesterol, protein and albumin between total gastrectomy groups and proximal gastrectomy groups (P>0.05). However, reflux complications were significantly more common in proximal gastrectomy groups (72.4%) than in total gastrectomy groups (29.5%). Severe reflux esophagitis (LA classification C or D) was found in only proximal gastrectomy groups. Conclusion: Total gastrectomy is favorable for proximal early gastric cancer in terms of reduced esophageal reflux complications. (J Korean Surg Soc 2010;79:246-252)