ObjectiveTo evaluate the short-term efficacy and safety of gastric interposition for digestive tract reconstruction after proximal gastrectomy.MethodsA retrospective study was conducted on 47 patients with Siewert Ⅱ-Ⅲ adenocarcinoma of the esophagogastric junction (AEG) who received radical surgery in the Department of Genera1 Surgery of Yangpu Hospital Tongji University between January 2021 and October 2023. Among them, 32 cases underwent total gastrectomy with Roux-en-Y anastomosis (TGRY), and 15 cases received proximal gastrectomy with gastric interposition anastomosis (PGGI). Surgical safety and efficacy were compared between the two groups.ResultsThe baseline characteristics between TGRY group and PGGI group were comparable (All P>0.05). No significant difference was observed between the two groups in the intraoperative and postoperative recovery indicators, including intraoperative blood loss, postoperative complication rate and length of postoperative hospitalization, etc (all P>0.05). There were 2 (13.3%) cases of Clavien-Dindo grade ≥Ⅱ complications in the PGGI group, but no severe complications such as anastomotic leakage or stenosis occurred. Moreover, no tumor recurrence or metastasis was detected in either group of patients within 6 months after surgery. The nutritional indicators of PGGI group were significantly better than those of TGRY group at postoperative 6 months, including body mass index, serum albumin, hemoglobin and mean corpuscular volume (all P<0.05). No megaloblastic anemia was observed in the PGGI group. The incidences of digestive discomfort (Visick scale 2-4) (6.7% vs 37.5%, P=0.037) and reflux esophagitis (Los Angeles grade B-D) (7.1% vs 42.3%, P=0.030) in the PGGI group were both significantly lower than those in the TGRY group 6 months after the surgery.ConclusionPGGI is safe and feasible for the patients with AEG. Compared with TGRY, PGGI can effectively improve patients' nutritional status and quality of life after surgery, and does not increase the risk of postoperative complications.