LAUSR

Key Points Question Is laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DTR) superior to laparoscopic total gastrectomy (LTG) for the treatment of patients with clinically early gastric cancer (GC) in the upper third of the stomach (upper-third early GC)? Findings In this randomized clinical trial of 138 patients with upper-third early GC, surgical treatment with LPG-DTR compared with LTG resulted in a significantly decreased mean amount of vitamin B12 supplementation (0.4 mg in the proximal gastrectomy group and 2.5 mg in the total gastrectomy group) but no significant difference in hemoglobin change (−5.6% in the proximal gastrectomy group and −6.9% in the total gastrectomy group). No increase in complication rates and no difference in overall and disease-free survival rates were found in those who received LPG-DTR vs LTG. Meaning These findings suggest that LPG-DTR may be superior to LTG with regard to vitamin B12 supplementation and as safe as LTG for the treatment of patients with upper-third early GC.