Intra-abdominal pressurized aerosol chemotherapy after proximal gastrectomy with double-tract reconstruction in a patient with locally advanced gastric cancer

Gastric cancer is a pressing problem in modern oncology. The most common surgical intervention for this localization is gastrecto-my with D2 lymph node dissection. However, if the tumor process is localized in the upper third of the stomach, proximal resection can be performed, since its effectiveness and safety have been proven. The disadvantages of organ-preserving operations in-clude the risk of developing reflux esophagitis. In recent years, proximal gastric resection with reconstruction using the double-tract method has been actively introduced. By forming three anastomoses, the risk of developing this complication is significantly re-duced. Peritoneal dissemination is the most common and early form of gastric cancer progression, accounting for up to 70% of cas-es. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a treatment method that has demonstrated an increase of overall survival in patients with synchronous peritoneal carcinomatosis. There are currently a number of studies underway to exam-ine this treatment option for prophylactic purposes in patients with locally advanced gastric cancer. The article presents a clinical case of a patient who underwent proximal gastrectomy with double-tract reconstruction with D2 lymph node dissection and prophylactic PIPAC after the neoadjuvant stage of treatment. Intraperitoneal pressurized chemotherapy has been shown to be safe, with organ-preserving intervention improving patients’ quality of life and promoting faster recovery. © 2025 Elsevier B.V., All rights reserved.