To compare the short-term clinical outcomes of totally laparoscopic proximal gastrectomy with double-channel anastomosis and total gastrectomy with Roux-en-Y anastomosis, and to explore the application effect of double-channel anastomotic reconstruction in the treatment of advanced Siewert typeⅡandⅢesophagogastric junction cancer (AEG).

The clinical data of 100 patients who underwent gastradenocarcinoma surgery were retrospectively analyzed. Propensity score matching (PSM) was performed using the 1:1 nearest neighbor matching method, and they were divided into the PG group (n=26) and the TG group (n=26) according to different resection scopes and anastomotic methods. R language software was used for data analysis. For measurement data, t test and Rank Sum test were used for intergroup comparison according to whether they conformed to normal distribution, and χ² test or Fisher’s exact probability method was used for intergroup comparison of categorical variables. Matching was performed by the 1:1 nearest neighbor matching method, and the caliper value was 0.25. P<0.05 was considered statistically significant.

Before PSM, there were statistically significant differences in age and antegrade/retrograde peristaltic anastomosis between the two groups (P<0.05). After PSM, 52 cases were successfully paired, 26 cases in each of the PG group and the TG group. There were no statistically significant differences between the two groups in intraoperative blood loss, time to first postoperative exhaust, T/N staging, intraoperative and postoperative complications, and nutritional indicators such as hemoglobin (Hb) and serum albumin (ALB) levels on the 1st, 3rd, 5th, 7th day and 1 month after surgery. The total number of lymph nodes dissected in the PG group was less than that in the TG group, (42.7±17.8) and (60.7±37.2), respectively, and the difference was statistically significant (P=0.032), but there was no statistically significant difference in the number of positive lymph nodes between the two groups (P>0.05).

Proximal gastrectomy for patients with advanced Siewert typeⅡandⅢAEG is safe and feasible in terms of oncology. Double-channel reconstruction after proximal gastrectomy is not inferior to total gastrectomy reconstruction in terms of postoperative nutritional status and quality of life.