doi:10.19538/j.cjps.issn1005-2208.2025.09.14

Chinese Journal of Practical Surgery ›› 2025, Vol. 45 ›› Issue (09) : 1036-1040. DOI: 10.19538/j.cjps.issn1005-2208.2025.09.14

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Abstract

To investigate the clinical value of the modified Overlap esophagojejunal angle-removing anastomosis in totally laparoscopic total gastrectomy. Methods The research group included 21 gastric cancer patients who underwent modified overlapping angle-removing anastomosis with total gastrectomy via laparoscopic surgery at the Department of Gastric and Colorectal Surgery, General Surgery Center, the First Hospital of Jilin University; Department of General Surgery, Liaoyuan People's Hospital; and Department of General Surgery Ⅱ, Liaoyuan Central Hospital between December 2024 and April 2025. The control group of 34 patients received conventional overlapping esophagal-jejunal anastomosis during the same period. The perioperative and short-term postoperative outcomes were compared between the two groups. Results Key steps of the modified Overlap esophagojejunal angle-removing anastomosis：The esophagus was transected horizontally with a linear cutter，an opening was made at the right angle of the esophageal stump，and an Overlap anastomosis was performed with the jejunum under the guidance of a gastric tube. The common anastomosis was closed in two steps using the linear cutter，while simultaneously removing the two weak angles of the esophageal stump. No statistically significant differences were observed in the general characteristics of the patients between the two groups (all P>0.05). All patients successfully underwent the surgery without conversion to open laparotomy. During dietary follow-up, all patients in the study group resumed semi-liquid or regular diets within 1 month postoperatively and were able to consume regular diets by 3 months postoperatively. No statistically significant differences were found between the two groups in terms of intraoperative hemorrhage volume, postoperative hospital stay, or incidence of anastomotic leakage (all P>0.05). Compared with the control group, the study group showed significantly shorter esophagojejunal anastomosis time ［(27.8±3.7) min vs. (37.9±3.4) min, t=-9.519, P<0.001］ and operative time ［(203.9±22.7) min vs. (215.1±14.5) min, t=-2.779, P=0.008］, with statistically significant differences (all P<0.05). Conclusion The modified Overlap esophagojejunal angle-removing anastomosis in totally laparoscopic total gastrectomy is operationally straightforward and preliminarily demonstrates safety and feasibility, warranting further validation.

Key words

modified Overlap / gastric cancer / total gastrectomy / laparoscopy / esophagojejunostomy

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