Modified overlap esophagojejunostomy in digestive tract reconstruction after laparoscopic total gastrectomy for gastric carcinoma

Objective To evaluate modified overlap esophagojejunostomy in digestive tract reconstruction of totally laparoscopie total gastrectomy(TLTG)in patients of gastric carcinoma. Methods The clinicalpathological data of 68 patients admitted to Hangzhou First People′s Hospital from Jun 2015 to Aug 2018 Undergoing totally laparoscopie total gastrectomy and modified overlap esophagojejunostomy were analyzed retrospectively. Results Procedures were successful in all 68 patients without conversion to open surgery and no perioperative death.The operation time, esophagojejunostomy time, volume of intraoperative blood loss and incision length were respectively (210±30)min, (25±12)min, (50±20)ml and(3.5±1.1)cm. Time for initial out of bed activity, time of initial anal exsufflation, time for postoperative fluid diet intake and duration of postoperative hospital stay were (24±8)h, (2.4±0.5)d, (3.1±0.8)d, and (8±3.6)d. There was anastomotic fistula in one and recovered by conservative treatment, total number of harvested LNs in 68 patients were (38.9±2.3). By pTNM staging: 6 cases in stage ⅠB, 10 cases in stage ⅡA, 20 cases in stage ⅡB , 15 cases in stage ⅢA, 12 cases in stage ⅢB, 5 cases in stage ⅢC. 59 patients were followed up from 3 to 42 months. One with liver metastasis after 22 months, others were all tumor-free. Conclusion The modified overlap esophagojejunostomy method is safe and feasible in digestive tract reconstruction of totally laparoscopie total gastrectomy for gastric carcinoma. Key words: Stomach neoplasms; Anastomosis, surgical; Gastrectomy; laparoscopy