Function-preserving surgery for gastric cancer: current status and future perspectives

Area of Science:

• Surgical Oncology
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Early gastric cancer (EGC) incidence is rising due to enhanced diagnostics.
• Function-preserving gastrectomy (FPG) aims to improve post-surgery quality of life (QOL).
• FPG offers low metastasis rates, excellent survival, and potential for minimally invasive approaches.

Purpose of the Study:

• To review the role and techniques of function-preserving gastrectomy (FPG) in early gastric cancer (EGC).
• To compare different FPG methods like pylorus-preserving gastrectomy (PPG) and laparoscopic proximal gastrectomy (LAPG).
• To highlight the benefits and challenges of FPG in improving patient QOL.

Main Methods:

• Review of existing retrospective studies on FPG techniques for EGC.
• Analysis of outcomes for pylorus-preserving gastrectomy (PPG) and laparoscopic proximal gastrectomy (LAPG).
• Discussion of technical difficulties and indications for FPG in upper gastric EGC.

Main Results:

• PPG is a representative FPG with reported benefits, indications, and limitations.
• LAPG for upper EGC faces challenges balancing swallowing and reflux prevention.
• Laparoscopy-assisted subtotal gastrectomy may offer better QOL and fewer complications for upper EGC.

Conclusions:

• FPG is recommended for accurately diagnosed EGC, but requires surgical skill.
• Laparoscopic FPG techniques present challenges for less experienced surgeons.
• Further prospective studies are essential to validate FPG's value against conventional methods.