To explore the application and efficacy of total laparoscopic λ-shaped uncut jejunojejunostomy in digestive tract reconstruction after proximal gastrectomy, and to provide a new option for digestive tract reconstruction following proximal gastrectomy.

A retrospective analysis was conducted on the clinical data of 11 patients who underwent total laparoscopic proximal gastrectomy with digestive tract reconstruction via λ-shaped uncut jejunojejunostomy from October 2023 to April 2024. Their clinical characteristics, perioperative indicators, postoperative outcomes, and follow-up results were analyzed. Gastroscopy, upper gastrointestinal radiography, and nutritional scoring were combined to evaluate postoperative reflux esophagitis and nutritional status of the patients.

All 11 patients successfully underwent the target surgical anastomosis for digestive tract reconstruction. The perioperative indicators were as follows: mean operation time (192.9±36.2) minutes, intraoperative blood loss (104.5±47.2) ml, time to first postoperative flatus (3.5±0.5) days, time to first oral intake (4.5±0.5) days, length of hospital stay (15.3±1.7) days, and the number of lymph nodes dissected was 44. The mean prognostic nutritional index (PNI) was (54.7±6.1) preoperatively, (45.2±6.3) at 1 month postoperatively, (49.7±3.5) at 6 months postoperatively, and (52.8±4.2) at 12 months postoperatively. No early complications occurred in the 11 patients. The total incidence of late complications was 27.2% (3/11): 1 case of esophageal anastomotic stricture, which improved after endoscopic dilation therapy; 1 case of reflux esophagitis (LA-B grade) and 1 case of gastroesophageal reflux symptoms, both of which were relieved after dietary education and drug treatment.

For early adenocarcinoma of the upper one-third of the stomach and Siewert type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction with a tumor diameter ≤ 4cm, total laparoscopic proximal gastrectomy combined with digestive tract reconstruction via λ-shaped uncut jejunojejunostomy is technically feasible and safe, with favorable short-term postoperative efficacy. This surgical approach is expected to provide a new option for digestive tract reconstruction after proximal gastrectomy.