Abstract
BACKGROUND: This study aimed to analyze the clinical efficacy of π-shaped esophagojejunostomy and the overlap method in treating upper gastric cancer with double-tract reconstruction in proximal gastrectomy under total laparoscopy. METHOD: Clinical data were collected from patients with upper gastric cancer who underwent surgery in the General Surgery Department of Jiangsu University Affiliated Hospital from June 1, 2017, to January 1, 2023. Patients were categorized into the overlap method group and the π-shaped esophagojejunostomy group. We collected perioperative and gastroscopy follow-up data from both groups 1 year after surgery. RESULTS: Seventy-nine patients were included, with 46 in the overlap anastomosis group and 33 in the π-shaped esophagojejunostomy group. Both groups were evaluated for age, sex, body mass index, tumor diameter, tumor pathological Tumor, Node, Metastasis staging, intraoperative bleeding volume, number of lymph node dissections, postoperative hospitalization days, postoperative hospitalization days, catheter removal time, drainage tube removal time, recovery time, anal defecation time, postoperative bedtime activity time, hospitalization cost, Visual Analog Scale (VAS) score at rest on the first day after surgery, VAS score at activity on the first day after surgery, short-term postoperative complications and 1-year gastroscopy follow-up. No significant difference was observed in these factors (P > 0.05). However, the π-shaped esophagojejunostomy group had a significantly lower surgical time and anastomosis time than the overlap anastomosis group (P < 0.05). CONCLUSION: Both overlap anastomosis and π-shaped esophagojejunostomy are safe for double-tract reconstruction in proximal gastrectomy under total laparoscopy without increasing the incidence of perioperative and short-term complications in patients. π-shaped esophagojejunostomy has shorter surgical time and anastomosis time than overlap anastomosis.