Indications and technical aspects of proximal gastrectomy

Area of Science:

• Oncology
• Surgical Gastroenterology

Background:

• Gastric cancer is a leading cause of cancer death globally.
• While overall incidence declines, proximal gastric cancer is increasing in developed nations.
• Current treatment disparities exist between Asian and Western countries.

Purpose of the Study:

• To evaluate the role of proximal gastrectomy in managing gastric cancer.
• To address the technical and oncological challenges of proximal gastrectomy.
• To compare outcomes of proximal gastrectomy versus total gastrectomy.

Main Methods:

• Review of current surgical interventions for gastric cancer.
• Analysis of endoscopic surgery techniques (EMR, ESD).
• Examination of guidelines from organizations like the Japanese Gastric Cancer Association (JGCA).

Main Results:

• Proximal gastrectomy with D1+ lymphadenectomy is recommended by JGCA for early gastric tumors.
• Western countries predominantly use total gastrectomy due to perceived surgical challenges.
• Proximal gastrectomy may reduce dumping syndrome and anemia, improving postoperative quality of life.

Conclusions:

• Proximal gastrectomy presents potential benefits for gastric cancer patients, including improved quality of life.
• Further definition of proximal gastrectomy's role in gastric cancer treatment is warranted.
• Bridging the gap between Asian and Western surgical practices for gastric cancer is crucial.