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.
Study Type
OBSERVATIONAL
Enrollment
250
Curative proximal gastrectomy followed by double-tract reconstruction performed as part of routine clinical care. The study does not assign treatment and retrospectively analyzes existing clinical data.
First Affiliated Hospital of Nanjing Medical University
Nanjing, Jiangsu, China
Moscow Clinical Scientific Center named after A.S. Loginov
Moscow, Russia
Endoscopic reflux esophagitis
Presence and severity of reflux esophagitis assessed by endoscopy using the Los Angeles classification (grades A-D).
Time frame: 1 year after surgery
Clinically significant reflux symptoms
Reflux symptoms assessed using the GERD-Q questionnaire; a total score greater than 8 is considered clinically significant reflux.
Time frame: 1 year after surgery
Change in body mass index
Change in body mass index, measured in kilograms per square meter.
Time frame: From preoperative baseline to 1 year after surgery
Change in serum albumin
Change in serum albumin concentration, measured in grams per liter.
Time frame: From preoperative baseline to 1 year after surgery
Change in hemoglobin
Change in hemoglobin concentration, measured in grams per liter.
Time frame: From preoperative baseline to 1 year after surgery
Perioperative outcomes-Operative time
Operative time in minutes
Time frame: From surgery through hospital discharge, up to 6 months
Postoperative complications
Overall complications, severe complications defined as Clavien-Dindo grade IIIa or higher, anastomotic leakage, and anastomotic stricture requiring endoscopic dilation or another intervention.
Time frame: Within 30 days after surgery
Overall survival
Time from surgery to death from any cause. Participants alive at last follow-up will be censored.
Time frame: From the date of surgery until death or last follow-up, up to 12 years
Disease-free survival
Time from surgery to first local, regional, or distant recurrence or death from any cause. Event-free participants will be censored at last follow-up.
Time frame: From the date of surgery until recurrence, death, or last follow-up, up to 12 years
intraoperative blood loss
intraoperative blood loss in milliliters
Time frame: from surgery to discharge, up to 6 months
postoperative length of hospital stay
postoperative length of hospital stay in days
Time frame: from surgery to discharge, up to 6 months.
conversion to open surgery
conversion to open surgery among patients undergoing minimally invasive surgery (percentage).
Time frame: from surgery to discharge, up to 6 months
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