| Objective: To compare the safety and short-term efficacy of two esophagojejunostomy methods,reverse puncture method and Overlap method,in total laparoscopic total gastrectomy for Siewert type II and III esophagogastric junction adenocarcinoma.Methods: A retrospective study of the clinical data of patients undergoing total laparoscopic total gastrectomy in the Third Department of General Surgery of Handan Central Hospital from August 2016 to August 2020 due to Siewert Ⅱ and Ⅲesophagogastric junction adenocarcinoma,There were 60 male cases and 9 female cases,32 cases of Siewert type II and 37 cases of Siewert type III.According to the different ways of anastomosis of the esophagus and jejunum during the operation,they were divided into the reverse puncture anastomosis group(n=38)using a circular stapler and the Overlap group using a linear stapler(n=31).The basic data,surgical data,postoperative recovery and postoperative complications of the two groups of patients were compared and analyzed.Results: There was no significant difference in age,BMI,tumor location,tumor diameter,tumor differentiation,Lauren classification,operation time,blood loss,number of lymph nodes removed,number of positive lymph nodes,tumor margin distance,intraoperative complications,postoperative recovery,operation cost and postoperative complications between the two groups of patients(P > 0.05).The reverse puncture group(56.02±12.21 min)is better than the overlap group(66.29±16.38 min)in the time of esophageal jejunum anastomosis P<0.05.Conclusion: The reverse puncture method and the Overlap method are both safe in the esophageal jejunal anastomosis during total laparoscopic total gastrectomy for Siewert type Ⅱ and Ⅲ esophagogastric junction adenocarcinoma.Compared with the Overlap method,the reverse puncture method has a slight advantage in the time of esophageal jejunal anastomosis because the operation is more convenient. |
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