Abstract:Objective: To investigate the methods of digestive tract reconstruction to reduce reflux in patients with proximal gastric cancer after gastrectomy. Methods: Two novel anastomosis procedures for proximal gastrectomy were designed, which were gastric cardia-preserving esophagogastrostomy and circular jejunal interposition pouch reconstruction. The clinical results of the two novel procedures were compared with those of the conventional proximal gastrectomy anastomosis and total gastrectomy. Results: The preoperative clinicopathologic data of the patients among the 4 groups were comparable (P>0.05). After surgery, the body weight and prognostic nutritional index on the 6th month had no significant differences among the groups (P>0.05), but both were significantly higher on the 24th month in the two groups with novel procedures than those in the groups with conventional procedures (P<0.05). The quality of life, incidence of esophageal reflux and Visick’s grade of the two groups with new procedures were significantly better than those of the groups with conventional anastomoses at 3 years after surgery (P<0.01). There were no statistical differences among the 4 groups in the 1-, 3- and 5-year survival rate (P>0.05). Conclusion: The proximal gastrectomy with gastric cardia preservation and circular jejunal interposition pouch reconstruction are hopeful to become new procedures for surgical treatment of cancer of the gastric fundus and cardia.