Safety evaluation and application of esophagojejunostomy in laparoscopic total gastrectomy / 中华消化外科杂志

ABSTRACT

The esophagojejunostomy is a key and difficult point in laparoscopic total gastrectomy (LTG),it mainly uses circular stapler and Endo-cutter.The circular stapler includes trans-orally inserted anvil (OrVilTM),purstring instrument,manual anastomosis,anti-puncture placement,etc;The Endo-cutter includes esophagus-jejunum side-to-side anastomosis and overlap side-to-side anastomosis.There are their respective advantages and limitations in the various esophagojejunostomy,no standard is recommended.When it comes to security,overlap side-to-side anastomosis is better for patients with non-upper gastric cancer,and OrVilTM really has a leading-edge advantage compared with other anastomoses and may be used for patients with upper gastric cancer who cannot undergo linear anastomosis.The above anastomosis methods need to be proved by the high-quality,large-sample randomized controlled clinical studies.