Objectives  To compare the safety and short-term curative effect of laparoscopic proximal gastrectomy (LPG) versus open proximal gastrectomy (OPG) in treating locally advanced proximal gastric cancer after neoadjuvant chemotherapy (NACT) and to investigate the rationality of surgical selection.

  Methods  The clinical data of 74 patients admitted for locally advanced proximal gastric cancer at Affiliated Hospital of Xuzhou Medical University between January 2018 and January 2020 were retrospectively analyzed. Sixty-six patients were enrolled after 1:1 matching through the propensity scoring method. All received neoadjuvant chemotherapy preoperatively. Thirty-four patients were assigned into the laparoscopic group and 32 patients into the open group. For the safety of the two groups during the operation and intraoperative postoperative related-index analysis, specifically for the patients with some clinical indicators, such as operation time, amount of intraoperative blood loss, dissected lymph node numbe, postoperative intestinal function recovery time, postoperative hospitalization time, and postoperative complications, the 18-month overall survival (OS) and disease-free survival (DFS) rates.

  Results  Laparoscopic surgery has more advantages with respect to the amount of intraoperative blood loss, postoperative hospital stay, exhaust time, and feeding time (P<0.05). However, the operation time was shorter and number of dissected lymph nodes was more in the open group than that in the laparoscopic group. Postoperative complications and the rate of the 18-month OS and DFS were not significantly different (P>0.05).

  Conclusions  Laparoscopic surgery can reduce intraoperative blood loss and postoperative recovery time, but it is inferior to open surgery in operative time and number of lymph nodes dissected. The safety and short-term efficacy of laparoscopic surgery deserve affirmation and long-term efficacy should be further studied.