To investigate the clinical outcome of totally laparoscopic total gastrectomy by using modified overlap esophagojejunostomy.

Retrospective analysis of clinical data were performed in 76 patients with gastric cancer who underwent totally laparoscopic total gastrectomy in two hospitals from March 2016 to December 2017. According to digestive tract reconstruction, patients were divided into traditional groups (40 cases, with traditional Overlap method) and the modified group (36 cases, modified Overlap method). Statistical analysis were performed by using SPSS 23.0 software. Measurement data with normal distribution, such as surgery-related indicators, postoperative recovery were expressed as (±s), and were examined by using an independent sample t test. Total incidence of complications and 2-year survival rate were expressed as rate, and were analyzed by using χ² test. A P value of <0.05 was considered as statistically significant difference.

There were no significant differences between the two groups in terms of tumor diameter, harvested lymph nodes, length of dissected esophageal margin, intraoperative blood loss, postoperative anal exhaust time, postoperative first feeding time, total hospital stay, and 2-year survival rate (P>0.05). Esophagojejunostomy time and operation time in the modified group were shorter than those in the traditional group respectively (P<0.05). The total complications incidence of 8.3%in the modified group was lower than 12.5% in the traditional group, with no statistically significant difference (P>0.05).

The modified Overlap method is safe and feasible for digestive tract reconstruction in totally laparoscopic total gastrectomy, which could shorten the time of intraoperative anastomosis and operation, with faster recovery.