Abstract：
Gastric cancer (GC) is one of the most malignant human cancers. Totally laparoscopic total gastrectomy (TLTG) is a difficult operation, especially esophagojejunostomy. Our team has adopted the method of suspending and pulling the esophagus with the visceral retractor and two needles of barbed wire interlocking to suture the common opening, which reduces the difficulty of the operation. From January to December 2020, 20 patients underwent TLTG with the overlap method by improved esophagojejunostomy technique and 20 patients with the traditional overlap method after TLTG were used as the control group. The surgery was performed using a five-trocar system. After lymphadenectomy, the esophagus was separated at least 2 cm from the upper edge of the tumor. Improved esophagojejunostomy technique was completed by the following steps: (1) cutting end of the esophagus suspension; (2) jejuno-jejunostomy; (3) esophagojejunostomy; (4) close the esophagojejunum common incision opening. The results showed that the operative time, and anastomosis time of the modified group were shorter than those of the traditional group, There were no postoperative complications such as anastomotic leakage, anastomotic stenosis, duodenal stump fistula and Roux stasis syndrome in the both group. There was no statistically significant difference in postoperative complications between the two groups. Taken together, our modified esophagojejunostomy technique after total gastrectomy is feasible and safe. This procedure is an efficient method to shorten the operation time and reduce the difficulty of surgery in esophagojejunostomy of laparoscopic total gastrectomy.
摘要：
胃癌(GC)是人类最恶性的癌症之一。全腹腔镜全胃切除术(TLTG)是一项困难的手术,尤其是食管空肠吻合术.我们的团队采用了用内脏牵开器和两针铁丝网互锁的方法来悬挂和拉动食道来缝合共同的开口，这降低了操作的难度。2020年1月至12月,采用改良食管空肠吻合术后重叠法TLTG20例,采用传统重叠法TLTG20例作为对照组。使用五套管针系统进行手术。淋巴结清扫术后,食管与肿瘤上边缘至少分开2cm。改良食管空肠吻合术通过以下步骤完成：（1）食管悬吊术切端；（2）空肠吻合术；（3）食管空肠吻合术；（4）关闭食管空肠常见切口开口。结果表明,手术时间,改良组吻合时间短于传统组，术后无吻合口瘘等并发症,吻合口狭窄,两组十二指肠残端瘘和Roux淤滞综合征。两组术后并发症比较差异无统计学意义。一起来看,全胃切除术后改良食管空肠吻合术是可行和安全的。该术式是腹腔镜全胃切除术食管空肠吻合术中缩短手术时间、降低手术难度的有效方法。
