To investigate the safety，feasibility and short-term efficacy of λ esophagojejunostomy in total laparoscopic radical gastrectomy.

A retrospective analysis was made of 20 patients with adenocarcinoma of the gastric/gastroesophageal junction who underwent radical total gastrectomy and λ esophagojejunostomy under total laparoscopy from January 2021 to July 2021. Complete case data and follow-up were available.

There were 12 males and 8 females，aged 42 to 76（60.9±5.6）years. There were 11 cases of adenocarcinoma of the gastroesophageal junction（9 cases of Siewert type Ⅱ；2 cases of Siewert type Ⅲ），9 cases of proximal gastric adenocarcinoma. All patients successfully completed radical gastrectomy and D2 lymph node dissection under total laparoscopy，and underwent gastrointestinal reconstruction with λ esophagojejunal anastomosis. The total operation time was 235-295（249.4±48.5）min，the reconstruction time of digestive tract was 48.2±23.2 min，and the intraoperative blood loss was 63.4±48.4 ml. Recovery exhaust time（3.1±2.2）d；First drinking or eating time（3.1±2.2）d，hospital stay（7.3±4.4）d；Postoperative complications occurred in 3 cases，including duodenal stump leakage combined with abdominal infection in 1 case，anastomotic hemorrhage in 1 case and postoperative inflammatory intestinal obstruction in 1 case，all of which were cured by conservative treatment. The nutritional index（PNI）of the 20 patients was 53.5±8.4 before surgery，47.3±5.6 1 week after surgery，50.3±5.6 6 months after surgery，and 52.4±4.2 12 months after surgery. The incidence of Roux-en-Y retention syndrome was 5.0%（1/20），the incidence of bile reflux esophagitis was 5.0%（1/20），there was no recanalization of the closed end of the input loop of the esophagojejunostomy，no anastomotic stenosis，obstruction，or anastomotic tumor recurrence.

λ esophagojejunal anastomosis is safe and feasible in total laparoscopic radical gastrectomy digestive tract reconstruction. This reconstruction method not only maintains intestinal continuity，but also simplifies the operation procedure，and the postoperative recovery is fast and the short-term effect is good.