To compare the clinical outcome of total gastrectomy and proximal gastrectomy for advanced proximal gastric cancer.

From January 2008 to March 2012, clinical data of 172 patients with advanced proximal gastric cancer in our hospital were analyzed retrospectively. According to operation methods, 172 patients were divided into proximal gastrectomy group (83 cases) and total gastrectomy group (89 cases). The operation data and complications of the patients were observed and recorded, and the survival, recurrence and metastasis of the patients were followed up for 5 years. SPSS24.0 statistical software was used for data analysis, Measurement data such as age, time of operation and amount of bleeding during operation were presented as (±s) and were examined by t test. Gender, tumor location and other disorder two classification data were examined by using chi square test, Tumor size, depth of infiltration and other ordered two categorical data were examined by rank sum test; Kaplan-Meier method was used by survival analysis. P<0.05 was thought to be statistically significant.

The operation time and the amount of bleeding of patients underwent total gastrectomy were more than those of patients underwent proximal gastrectomy (P<0.05). However, there was no significant difference between 2 groups in terms of other intraoperative and postoperative indicators. Compared with proximal gastrectomy, patients received total gastrectomy had significantly lower incidence of complications such as gastric emptying dysfunction, leakage and reflux esophagitis (P<0.05). 1 year , 3 year and 5 year survival in proximal resection group were 71.1%, 45.5% and 34.2%, respectively, which were significantly lower than 83.1%, 67.2% and 56.6% in total gastrectomy group (F=10.746, P=0.001).

Total gastrectomy could reduce the incidence of postoperative complications, and prolong the postoperative survival.