To study the therapeutic effect of dual-endoscope combined function-preserving gastrectomy (FPG) for early proximal gastric cancer.

A retrospective cohort study was conducted to analyze the clinical data of 120 patients with early proximal gastric cancer (EGC) from January 2021 to October 2023. According to different surgical methods, the patients were divided into the observation group (n=68) and the control group (n=52). Patients in the observation group underwent endoscopic submucosal dissection (ESD) combined with laparoscopic lymph node dissection (LLND); patients in the control group underwent laparoscopic proximal gastrectomy (LPG). Data were analyzed using SPSS 24.0 software. Perioperative indicators and other measurement data with normal distribution were expressed as (±s) and analyzed by independent samples t test; counting data such as the incidence of postoperative complications were expressed as [cases (%)] and compared by χ² test; TNM staging data were expressed as case numbers and compared by Rank Sum test; Kaplan-Meier method was used to draw curves, and Log-Rank test was used for survival analysis. P<0.05 was considered statistically significant.

There was no statistically significant difference in the total number of dissected lymph nodes between the two groups (P>0.05). Compared with the control group, the observation group had longer operation time, less intraoperative blood loss, lower pain level, shorter gastric tube indwelling time, fasting time, and hospital stay (P<0.05). The total incidence of postoperative complications in the control group was 28.9%, which was higher than 2.9% in the observation group. In terms of Clavien-Dindo complication classification, the observation group was significantly milder than the control group (observation group: 1 case of grade Ⅰ, 1 case of grade Ⅱ, 0 cases of grade Ⅲ; control group: 8 cases of grade Ⅰ, 5 cases of grade Ⅱ, 2 cases of grade Ⅲ) (P<0.05). There were no statistically significant differences in preoperative Gastrointestinal Quality of Life Index (GLQI) and Patient-Generated Subjective Global Assessment (PG-SGA) scores between the two groups (P>0.05). At 6 and 12 months after surgery, compared with the control group, the observation group had significantly higher GLQI scores and significantly lower PG-SGA scores (P<0.05). There was no statistically significant difference in disease-free survival rate between the control group and the observation group (Log-Rank χ²=0.367, P>0.05).

Compared with LPG, dual-endoscope radical gastrectomy with LLND shows more significant advantages in perioperative indicators, quality of life, and postoperative nutritional improvement in patients with proximal EGC. LLND surgery helps reduce intraoperative bleeding, shorten postoperative recovery time, and significantly improve patients’ postoperative quality of life.