Application of a New Surgical Technique in Proximal Gastrectomy: a Prospective, Multicenter Randomized Controlled Study

Inclusion criteria

• 18 years old ≤ 80 years old;
• The primary tumor lesion is located in the upper part of the stomach or the esophagogastric junction (Siewert II or III), and it is expected that R0 surgical results can be obtained by performing proximal gastrectomy and D2 dissection；
• The primary lesion was diagnosed as adenocarcinoma through endoscopic biopsy and histopathological examination;
• If it is upper gastric adenocarcinoma, the clinical TNM staging based on imaging needs to be cT1N0M0. If it is ductal gastric junction adenocarcinoma, it needs to be cT1-3N0-1M0, and clinical imaging judgment shows no distant gastric lymph node metastasis；
• Expected survival exceeds 6 months;
• No history of upper abdominal surgery (excluding laparoscopic cholecystectomy);
• No chemotherapy, radiotherapy, targeted therapy, immunotherapy, etc. were performed before surgery;
• Preoperative ECOG (Eastern Cooperative Oncology Group) physical status score 0/1;
• Preoperative ASA (American Society of Anesthesiologists) grading I-III ;
• Good function of important organs;
• Sign the patient's informed consent form

Exclusion criteria

• Preoperative imaging examination suggests the fusion of enlarged lymph nodes (maximum diameter ≥ 3cm) in the area;
• Pregnant and lactating women;
• Suffering from other malignant tumors within 5 years;
• Preoperative body temperature ≥ 38 ℃ or complicated with infectious diseases requiring systematic treatment;
• Serious mental illness;
• Severe respiratory diseases, FEV1<50% of the expected value;
• Severe liver and kidney dysfunction;
• History of unstable angina or heart attack within 6 months;
• History of cerebral infarction or cerebral hemorrhage within 6 months, excluding old intracavitary infarction;
• Apply systemic corticosteroid therapy within one month;
• Patients with complications of gastric cancer (bleeding, perforation, obstruction) requiring emergency surgery;
• The patient has participated or is currently participating in other clinical studies (within 6 months)