Pylorus-preserving gastric resections for early gastric cancer: a clinical case report

Due to the development of screening programs, an increase in the detection rate of gastric cancer at early stages is being observed in the Russian Federation, which undoubtedly contributes to increased patient survival. In this context, the quality of life of patients after surgery becomes extremely relevant, serving as a prerequisite for the improvement and search for new surgical techniques in early-stage disease. In recent decades, there has been a trend towards an increase in the number of organ-preserving surgeries for gastric cancer. This article provides a review of global data on the technique of pylorus-preserving resection/gastrectomy, along with our own clinical observation. Undoubtedly, the pylorus performs critically important functions: it regulates the evacuation of gastric contents into the duodenum, prevents the rapid passage of undigested food and the reflux of bile back into the stomach. Removal of the pylorus during gastric resections is the main cause of such severe functional disorders as dumping syndrome and reflux. Modern studies have convincingly proven that for early gastric cancer (cT1N0, especially in the middle third of the stomach, without signs of lymph node involvement or subserosal invasion) and strict adherence to the principles of oncological radicality (adequate resection margins, D2 lymphadenectomy), pylorus-preserving resections provide equal 5-year overall and relapse-free survival rates compared to subtotal distal resections, while offering significant functional advantages, which is undoubtedly associated with an improved quality of life for patients.

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