Clinical comparison of antrum-preserving double tract reconstruction vs roux-en-Y reconstruction after gastrectomy for Siewert types II and III adenocarcinoma of the esophagogastric junction

Table 1 Pathological characteristics of the antrum-preserving double-tract reconstruction group and the Roux-en-Y reconstruction group

Pathologic characteristic	ADTR (n = 18)	RY (n = 37)	P value
Sex ratio (Male:Female)	17:1	31:6	0.406
Age (yr)	61.94 ± 6.41	62.08 ± 7.98	0.950
BMI (kg/m2)	21.50 ± 2.61	20.98 ± 2.66	0.683
Siewert type			0.497
II	7	11
III	11	26
pT status			0.744
T1a	0	0
T1b	3	3
T2	1	4
T3	2	5
T4a	12	25
Lymph node metastasis			0.709
pN0	6	8
pN1	4	9
pN2	7	15
pN3a	1	5
pN3b	0	0
Tumor TNM stage			0.002
Ia	3	0
Ib	2	0
IIa	1	4
IIb	1	6
IIIa	3	3
IIIb	7	7
IIIc	1	17
Histological type			0.002
Well differentiated	3	16
Moderately differentiated	11	13
Poorly differentiated	4	8

ADTR: Antrum-preserving double-tract reconstruction; RY: Antrum-preserving double-tract reconstruction; TNM: Tumor-node-metastasis.

Table 2 Comparison of perioperative outcomes between the antrum-preserving double-tract reconstruction group and the Roux-en-Y reconstruction group

Clinical feature	ADTR (n = 18)	RY (n = 37)	P value
Postoperative hospital stay (d)	12.88 ± 5.81	14.08 ± 5.85	0.495
Operating time (min)	282.22 ± 77.93	274.86 ± 63.23	0.709
Intraoperative blood loss (mL)	362.77 ± 294.15	270.81 ± 148.22	0.601
First flatus time (d)	2.94 ± 0.83	3.97 ± 1.11	0.002
Time to resume liquid diet (d)	4.47 ± 1.28	6.11 ± 1.82	0.001

ADTR: Antrum-preserving double-tract reconstruction; RY: Antrum-preserving double-tract reconstruction.

Table 3 Postoperative complications in the antrum-preserving double-tract reconstruction group and Roux-en-Y reconstruction groups

Complication	ADTR (n = 18)	RY (n = 37)	P value
Anastomosis-related complications
Anastomotic leakage	1	0	0.148
Anastomotic stenosis	0	1	0.481
Anastomotic hemorrhage	0	0	-
Early complications
Wound infection	2	3	0.716
Respiratory infection	1	4	0.525
Pleural effusion	2	3	0.716
Lymphorrhagia	1	3	0.732
Long-term complications
Reflux esophagitis	0	6	0.048
Cholelithiasis	1	3	0.732
Tumor recurrence	1	6	0.266
Tumor metastasis	1	5	0.374
Overall postoperative complication	3	7	0.839

Table 4 Univariate Cox regression analysis of overall survival among patients with gastrectomy

Characteristic	HR	95%CI	P value
Age	1.110	1.04-1.19	0.003
Gender	9.160	1.47-56.93	0.018
BMI	0.821	0.68-0.99	0.039
Surgical method	0.573	0.16-2.13	0.406
Intraoperative blood loss	1.000	0.99-1.01	0.496
Length of postoperative hospital stay	1.030	0.92-1.14	0.628
Pleural effusion	24.280	5.53-106.50	< 0.001
Time to first flatus	0.685	0.49-0.96	0.448
Time to resuming a liquid diet	0.685	0.49-0.96	0.026
Lymphorrhagia	9.620	1.48-62.54	0.018
TNM stage	2.310	1.59-3.35	< 0.001

BMI: Body mass index; TNM: Tumor-node-metastasis.

Table 5 Multivariate Cox regression analysis of overall survival among patients with gastrectomy

Characteristic	HR	95%CI	P value
Age	1.13	1.06-1.22	0.001
Gender	6.29	1.01-39.17	0.049
Pleural effusion	22.77	4.35-119.124	< 0.001
Time to resuming a liquid diet	0.65	0.45-0.93	0.020
Lymphorrhagia	15.14	1.84-124.47	0.011
TNM stage
1	0	0	0.982
2	0.02	0.01-0.350	0.003
3	0.19	0.01-0.651	0.146
4	0.05	0.01-0.484	0.007
5	0.03	0.01-0.446	0.009
6	0.43	0.16-1.13	0.087

TNM: Tumor-node-metastasis.