Controversies and consensuses on totally laparoscopic digestive tract reconstruction after gastrectomy for esophagogastric junction cancer
XU Ze-kuan
WANG Lin-jun
XU Hao
Abstract：Totally laparoscopic digestive tract reconstruction after gastrectomy for esophagogastric junction cancer is divided into totally laparoscopic reconstruction after proximal gastrectomy and totally laparoscopic reconstruction after total gastrectomy.The two types of reconstruction are divided into different methods,and some methods remain controversial.As to the extent of gastrectomy for esophagogastric junction cancer,total gastrectomy is the main method,while the application of proximal gastrectomy is still limited.However,the usage of anti-reflux reconstruction after proximal gastrectomy is expected to improve the indication of proximal gastrectomy.Circular-shaped anastomosis can obtain higher esophageal margin,and is applied for all types of esophagogastric junction cancer.While,the whole process of linear-shaped anastomosis can be performed laparoscopically,and it is mainly suitable for Siewert type Ⅲ esophagogastric junction cancer.As to totally laparoscopic reconstruction after total gastrectomy,the focus of controversy is that how to ensure the safety of esophagojejunostomy and reduce the incidence of anastomotic complications.As to totally laparoscopic reconstruction after proximal gastrectomy,high levels of evidence is needed to confirm the anti-reflux functions of reconstruction methods.In clinic,surgeons should select suitable digestive tract reconstruction method on the basis of the general principles of digestive tract reconstruction and patient-centered principle,combining with the patient's condition.
Keywords：esophagogastric junction cancerlaparoscopegastrectomydigestive tract reconstructionanastomosis
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 167-171 )