Abstract:

Objective

To explore the short-term efficacy of thoracoscopic and laparoscopic combined with intrathoracic anastomosis of the esophagus and residual stomach in the treatment of Siewert type Ⅱ adenocarcinoma of the esophagogastric junction （AEG）.

Methods

The clinical data of 33 patients with Siewert type Ⅱ adenocarcinoma of the esophagogastric junction from June 2021 to April 2023 were retrospectively analyzed.The statistical software SPSS25.0 was used for data analysis.Measurement data such as perioperative indexes and the scores of gastroesophageal reflux disease （GERD） scale were expressed as（±s），and paired t test was performed.The postoperative complication grading was evaluated using the Clavien-Dindo grading system，and the counting data were expressed as［ cases （%）］.A P value less than 0.05 was considered statistically significant.

Results

All 33 patients completed the thoracoscopic and laparoscopic combined with intrathoracic anastomosis of the esophagus and residual stomach.The operation time was （262.3±37.3）minutes，the intraoperative blood loss was （178.8±111.8） ml，and the postoperative hospital stay was （11.4±3.6）days.Anastomotic leakage occurred in 2 （6.1%） patients and pulmonary infection occurred in 1 （3.0%） patient after surgery，both of which were Clavien-Dindo grade Ⅱ，and they were cured after symptomatic supportive treatments such as anti-inflammatory and nutritional treatments.All patients had negative surgical margins postoperatively，without anastomotic stricture，anastomotic bleeding or death.

Conclusion

Thoracoscopic and laparoscopic combined with intrathoracic anastomosis of the esophagus and residual stomach is safe and feasible in the treatment of Siewert type Ⅱ AEG，and it will not increase the risk of postoperative complications.

Key words: Esophagogastric Junction Adenocarcinoma, Gastrectomy with Curative Intent, Proximal Gastrectomy, Gastrointestinal Reconstruction, Tubular Gastric Anastomosis