الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Gastric cancer is the second leading cause of cancer related mortality and the fourth most common cancer globally. The incidence of proximal gastric cancer has gradually increased.
For primary gastric cancer located in the upper third of the stomach, we perform proximal gastrectomy. Proximal gastrectomy for upper third gastric cancer theoretically allows the storage, digestion, and absorption of food and prevents anemia. Various methods of resection with reconstruction have been devised over time.
The application of open proximal gastrectomy is limited by the three main concerns: the first, oncological safety; the second, functional benefits, and the third, anastomosis-related late complications. Two types of post- open proximal gastrectomy reconstruction methods are known the esophagogastrostomy and esophagojejunostomy.
Many modified esophagojejunostomy procedures have been tried in place of an esophagogastrostomy in an effort to prevent late complications as jejunal interposition, jejunal pouch interposition, double tract reconstruction, and more.
Double tract reconstruction after open proximal gastrectomy is the preferred anastomosis method over jejunal interposition or jejunal pouch interposition for reducing subjective symptoms, as double tract reconstruction involves two food passages.
The aim of this study was to evaluate esophago-jejunostomy with double tract
reconstruction after Proximal Gastrectomy in cases of gastric cancer. Evaluation was done about weight loss after the procedure, operative time and reflux of gastric contents.
The study was carried out on 20 patients with upper third gastric cancer, who were admitted to General Surgery Department, Faculty of Medicine, Menoufiya University.
All patients above 36 years and up to 75 years were included in this study especially with a predictive proximal cancer feasible for resection and without other malignant diseases.
Evaluation will include: full history taking; physical examination ”general and local”; full investigation to diagnose the size and extent of the tumor; During the operative procedure the operative time, blood loss and intraoperative complications were detected while during the post-operative period all patients of the study will be followed up for complications detection, hospital stay and nutritional status.
Our results revealed that the age of patients in the study ranged between 38-68 years with a mean age of 53.278.9 with 30% of cases were females while 70% were males.
The operative time in our patients ranged between 80-130 min; while the intraoperative blood loss ranged between 50-120 ml.
The intra-operative complications were in the rate of 20% in the form of bleeding 15% and splenic injury 5%, while the postoperative complications occurred in 30% of cases in the form of wound infection, leakage suture lines and reflux.
from our study we can concluded that esophago-jejunostomy with Double tract reconstruction after proximal gastrectomy is an effective procedure as a management of proximal gastric cancer because it carries better late outcome. So, we recommended the use of this procedure to avoid late outcome complications.