Short-term efficacy and quality of life between circular and linear gastroesophageal anastomosis for gastric tubular reconstruction after laparoscopic proximal gastrectomy for gastric cancer

Abstract Background Gastric tubular reconstruction (GTR) is a commonly used anti-reflux reconstruction method after proximal gastrectomy. This study compares the short-term efficacy and quality of life (QoL) between totally laparoscopic proximal gastrectomy using an endoscopic linear stapler with laparoscopic-assisted proximal gastrectomy using a circular stapler for GTR to provide a reference for the rational selection of anastomotic devices in clinical practice. Methods A retrospective analysis of 111 upper gastric cancer patients undergoing laparoscopic proximal gastrectomy with GTR was conducted from October 2021 to April 2024. Patients were divided into CS (48 cases) and LS (63 cases) groups. Baseline characteristics, perioperative indicators, and short-term efficacy were compared. QoL was assessed using EORTC QLQ-C30 and QLQ-STO22 at three months postoperatively, and gastroscopy at six months evaluated reflux esophagitis. Results No significant baseline differences were found. The LS group had less intraoperative bleeding, faster recovery, and shorter hospital stay compared to CS ( P < 0.05). No differences in operation time, lymph node dissection, complication rates, or nutritional status were observed ( P > 0.05). QoL and reflux esophagitis incidence were similar between groups ( P > 0.05). Conclusion Compared with CS for GTR, the LS group had less intraoperative bleeding, faster postoperative recovery and shorter hospital stay. The QoL, nutritional status and incidence of reflux esophagitis of the two groups were comparable.