{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T15:20:09Z","timestamp":1776525609157,"version":"3.51.2"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effects of laparoscopic radical proximal gastrectomy with double-tract reconstruction (LPG-DTR) vs. laparoscopic radical total gastrectomy with Roux-en-Y reconstruction (LTG-RY) on tolerance to postoperative adjuvant chemotherapy in early-stage upper gastric cancer, providing evidence for surgical strategy selection and its impact on chemotherapy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective cohort study, clinical data were collected from 76 patients with early-stage upper gastric cancer who underwent postoperative chemotherapy following either LPG-DTR or LTG-RY at our institution between January 2020 and January 2023. Patients were stratified into the DTR group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935) and RY group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200941) based on surgical approach and digestive reconstruction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the R-Y group, the DTR group had a longer operation time, and a smaller number of lymph node dissections (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05).Chemotherapy completion rates showed no significant intergroup difference (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05).The DTR group demonstrated:Lower incidence of grade \u22652 adverse events (per CTCAE v5.0 criteria), Reduced requirement for granulocyte colony-stimulating factor (G-CSF)Increased utilization of antiemetics (e.g., ondansetron, azasetron) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LPG-DTR is associated with attenuated myelosuppression and decreased incidence of specific chemotherapy-related toxicities (thrombocytopenia, hepatotoxicity, peripheral neuropathy). Preservation of partial gastric function may underlie these advantages and potentially improve quality of life during adjuvant treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1647340","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T06:43:43Z","timestamp":1766040223000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Does different surgical approaches affect tolerance to postoperative adjuvant chemotherapy in early-stage upper gastric 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