Multicenter clinical application of regulatory dual-channel digestive tract reconstruction with pylorus-preserving approach in advanced gastric cancer

Background To evaluate the clinical significance of regulatory dual-channel digestive tract reconstruction with a pylorus-preserving approach in advanced gastric cancer through a multicenter study. Methods A total of 137 gastric cancer patients who underwent radical gastrectomy at three hospitals in Mianyang, China, between March 2018 and March 2023 were included. Patients were divided into a study group (n=68) undergoing regulatory dual-channel reconstruction with pylorus preservation and a control group (n=69) receiving total gastrectomy with Roux-en-Y reconstruction. Operative time, intraoperative blood loss, postoperative complications, and quality of life were compared. Results No significant differences were found between the groups regarding demographic and clinical characteristics, operative time, intraoperative blood loss, gastrointestinal function recovery, or hospital stay (P>0.05). Postoperative complications, including pulmonary infections, anastomotic leakage, gastrointestinal bleeding, and reflux esophagitis, also showed no significant differences (P>0.05). However, dumping syndrome was significantly less frequent in the study group (P<0.05). Both groups showed improvement in functional status and overall health from 1 to 24 months postoperatively. The study group had significantly higher physical function scores at 24 months (P<0.05), along with better emotional function and overall health scores from 6 to 24 months (P<0.05). Additionally, diarrhea scores were significantly lower in the study group at 1 and 6 months (P<0.05), while other functional and symptom domains showed no differences (P>0.05). Conclusion Regulatory dual-channel digestive tract reconstruction with pylorus preservation is a safe and effective approach that improves postoperative quality of life in patients with advanced gastric cancer. Synopsis Pylorus-preserving dual-channel reconstruction in advanced gastric cancer improves quality of life, reduces dumping syndrome, and shows comparable safety to total gastrectomy with Roux-en-Y.