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| Research progress in appetite-preserving gastrectomy |
| Chen Wenjing, Cheng Jun |
| Department of Gastrointestinal Surgery The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000 Zhejiang China |
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Abstract Appetite-preserving gastrectomy APG is a novel function-preserving surgical approach recently proposed in gastric
cancer surgery. Its core principle involves the precise preservation of the fundus and fornix—the primary secretion area of ghrelin—to
ensure oncological radicality while maintaining postoperative appetite thereby improving nutritional status and quality of life. This
article provides a systematic review of the definition theoretical foundation clinical efficacy current controversies and future
directions of APG. Current evidence suggests that APG demonstrates favorable perioperative safety in patients with esophagogastric
junction cancer and offers advantages in short - term appetite preservation weight change and nutritional indicators. However
controversies remain regarding its long-term oncological safety certainty of functional benefits and patient selection criteria. There is
an urgent need for large-scale multi-center randomized controlled trials to provide higher-level evidence. Future development of APG
should focus on precise patient selection technical standardization application of minimally invasive platforms and multidisciplinary
integrated management to promote its advancement toward a safer more effective and individualized approach.
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