Photo Credit: Pikovit44

The following is a summary of “Comparison of short-term efficacy of laparoscopic proximal gastrectomy with modified side overlap anastomosis and laparoscopic total gastrectomy with Roux-en-Y anastomosis,” published in the March 2025 issue of the BMC Gastroenterology by Wu et al.

This study aimed to evaluate the short-term efficacy of laparoscopic proximal gastrectomy (LPG) with modified side overlap anastomosis in comparison with laparoscopic total gastrectomy (LTG) with Roux-en-Y anastomosis for the treatment of upper gastric adenocarcinoma. Among these, 20 patients who underwent LPG with modified side overlap anastomosis were assigned to the side overlap group, while 242 patients who underwent LTG with Roux-en-Y anastomosis were categorized into the Roux-en-Y group. Using propensity score matching (1:1), 15 patients from each group were included in the final analysis. Key outcome measures included intraoperative conditions, postoperative recovery, and follow-up data.

In terms of intraoperative conditions, digestive tract reconstruction time was longer in the side overlap group compared to the Roux-en-Y group. However, there was no significant difference between the two groups regarding total operative time or intraoperative blood loss. Postoperatively, there were no statistically significant differences in first anal exhaust time, first postoperative liquid intake time, length of hospital stay, or postoperative complications between the two groups. Follow-up data revealed that at 12 and 18 months post-surgery, the side overlap group exhibited better nutritional outcomes, as evidenced by higher BMI, hemoglobin, albumin levels, and improved Nutritional Risk Screening 2002 (NRS-2002) scores, compared to the Roux-en-Y group. However, no significant differences were observed between the two groups in terms of gastroesophageal reflux disease (GERD) scale scores or the incidence of Grade B or higher reflux esophagitis at both follow-up intervals.

These findings suggest that LPG with modified side overlap anastomosis is a safe and feasible surgical approach for upper gastric adenocarcinoma, offering effective antireflux benefits. Additionally, compared to LTG with Roux-en-Y anastomosis, LPG appears to better preserve postoperative nutritional status, highlighting its potential as a viable alternative for select patients. Further prospective studies with larger sample sizes are warranted to validate these findings and optimize surgical strategies for upper gastric cancer management.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03724-2