食欲保留胃切除术(APG)是近来胃癌外科提出的一种新型功能保留手术,其核心关键在于通过精准保留胃底穹窿 部饥饿素主要分泌区域,在保证肿瘤根治的同时维持术后食欲,改善患者营养状况及生活质量。 本文对 APG 的定义与理论基 础、临床疗效、当前争议及未来发展方向进行了系统回顾。 现有研究显示 APG 在食管胃结合部肿瘤患者中具有良好的围手术 期安全性,并在术后短期食欲维持、体重变化及营养指标方面存在优势;然而其长期肿瘤学安全性、功能效益的确定性以及适 应证选择上仍然存在争议,亟需多中心、大样本随机对照试验以提供更高等级证据。 未来 APG 的发展应注重患者精准选择、 技术规范、微创平台应用及多学科综合管理,从而推动其向更安全、有效和个体化的方向迈进。

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.