Sino-Russian Comparison of Outcomes After Proximal Gastrectomy With Double-Tract Reconstruction

Surgical Outcomes and Long-Term Survival of Proximal Gastrectomy With Double-Tract Reconstruction at High-Volume Centers in Russia and China: A Two-Center Retrospective Analysis

This two-center retrospective observational cohort study compares Chinese and Russian patients who underwent curative proximal gastrectomy with double-tract reconstruction for proximal gastric adenocarcinoma or Siewert type II/III adenocarcinoma of the esophagogastric junction. The study evaluates postoperative reflux, nutritional status, perioperative outcomes, complications, and long-term survival. Propensity score matching will be used to improve comparability between the two cohorts.

Inclusion Criteria:

1. Age 18 to 75 years.
2. Histologically confirmed gastric adenocarcinoma or Siewert type II/III adenocarcinoma of the esophagogastric junction.
3. Underwent proximal gastrectomy with double-tract reconstruction.
4. Surgery performed with curative intent.
5. At least one valid postoperative follow-up record containing reflux, nutritional, or complication information.
6. Clinical, pathological, operative, and follow-up data sufficiently complete for analysis, with less than 20 percent missingness in key variables.

Exclusion Criteria:

1. Previous gastric or esophageal surgery, except limited endoscopic treatment such as endoscopic mucosal resection.
2. Synchronous or metachronous malignancy, except cured non-melanoma skin cancer or cervical carcinoma in situ.
3. Complete absence of follow-up data.
4. Double-tract reconstruction not completed or changed to another reconstruction method.
5. Severe preoperative reflux disease, defined as GERD-Q score greater than 8 with a requirement for long-term medication.