Choices and evaluation of digestive tract reconstructive procedures for patients with  adenocarcinoma of the  esophagogastric junction        LIANG Han. Department of Gastrointestinal Tumor Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
Abstract    Proximal gastrectomy is adequate only for early gastric cancer located in the upper third of stomach. Patient with reconstruction by esophagogastric end-to-end anastomosis suffers postoperative reflux symptoms and esophagitis. Patient with esophagogastric anterior wall end-to-side anastomosis combined with pylorplasty showes good postoperative quality of life such as recovery of body weight, less discomfort after meals and less heart burn or belching. Gastric tube reconstruction reduces postoperative gastroesophageal reflux since it functions for food storage and digestion although it is small. Jejunal interposition reconstruction maybe a good candidate for reconstructive surgery and a jejunal pouch interposition can increase the volume of remaining stomach. The advantage of double tract reconstruction may be demonstrated when a jejunal pouch to the oral side of the duodenum is added.