Laparoscopic radical proximal gastrectomy with double flap technique for early proximal gastric cancer: a prospective, phase II study

Background Proximal gastrectomy preserves gastric function but is limited by postoperative reflux. The double flap technique (DFT) offers an anti-reflux reconstruction, yet prospective evidence in China is lacking. Methods This prospective, single-center phase II study evaluated the safety and efficacy of laparoscopic proximal gastrectomy with DFT (LPG-DFT) for early proximal gastric cancer. Primary outcome was reflux esophagitis at 12 months; secondary outcomes included perioperative results, nutrition, and quality of life (QoL). Results Twenty patients underwent LPG-DFT without intraoperative complications or conversion. All achieved R0 resection, with a mean of 27.3 ± 8.9 lymph nodes harvested. No patient developed Los Angeles grade B or higher reflux at 12 months. Nutritional parameters showed only slight, nonsignificant declines. QoL scores decreased temporarily at 3 months but returned to baseline by 12 months. No major complications or mortality occurred. Conclusion LPG-DFT is safe, effectively prevents reflux, and preserves nutrition and QoL, supporting its use in early proximal gastric cancer.