Short-term and long-term outcomes comparisons between esophagogastrostomy and double tract reconstruction for proximal gastrectomy based on Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 in a Chinese population-based cohort

Purpose The optimal reconstruction method following proximal gastrectomy remains controversial. This study aims to compare the short- and long-term outcomes of esophagogastrostomy reconstruction (EGR) and double-tract reconstruction (DTR). Methods We retrospectively collected data from patients who underwent DTR or EGR between June 2014 and January 2020. We compared clinicopathological characteristics and short-term surgical outcomes. Long-term quality of life (QOL) assessments were performed and compared using the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45. Results Thirty-three to 39 patients who underwent DTR and EGR respectively were included in this study. The EGR group had higher body mass index than the DTR group (24.95 ± 3.26 vs. 23.43 ± 2.84, p = 0.039). There was no significant difference between the two groups in terms of surgical safety and feasibility. QOL analysis based on PGSAS-45 showed that the EGR group lost significantly more weight (-17.60% ± 10.00% vs. -12.30% ± 9.60%, p = 0.028) and had lower score of quality of ingestion ((3.04 ± 0.68 vs. 3.45 ± 0.75, p = 0.019). Multivariate analysis suggested that reconstruction mode was independently associated with body weight loss and quality of ingestion score ( p < 0.05). There was no significant difference between the two groups in terms of subjective symptom assessment. Conclusion The DTR group showed similar short-term outcomes to the EGR group, and slightly better QOL outcomes. Both reconstruction methods remain optional, and future studies with larger samples will help confirm our findings.