Abstract:

Gastric cancer, a prevalent gastrointestinal malignancy in East Asian countries, particularly Japan, Korea, and China, is undergoing a significant shift in treatment paradigms, moving from radical resection toward function-preserving precision therapy. In March 2025, the 7th edition of the Japanese Gastric Cancer Treatment Guidelines was released, updating the indications and technical standards for function-preserving gastrectomy, thereby providing critical guidance for clinical practice. This article systematically reviews key updates in the new guidelines, including expanded indications for endoscopic treatment of early gastric cancer, technical nuances of various function-preserving procedures, and criteria for selecting appropriate surgical approaches. Special emphasis is placed on the clinical value of pylorus-preserving gastrectomy, subtotal gastrectomy, and anti-reflux reconstruction techniques following proximal gastrectomy. The findings aim to off er evidence-based insights and technical references for standardizing function-preserving gastrectomy in China.

Key words: Gastric cancer, Function-preserving, Proximal gastrectomy