Abstract: Objective To investigate the feasibility and safety of clinical application of delta-shaped esophagojejunostomy using overlap method in laparoscopic total gastrectomy and proximal gastrectomy for gastric cancer. Methods The clinical data of 9 patients with gastric cancer who underwent laparoscopic radical gastrectomy from October 2017 to March 2018 was retrospectively analyzed. There were 4 cases with proximal gastric cancer using laparoscopic radical proximal gastrectomy with double-tract reconstruction and 5 cases including 1 case with proximal gastric cancer and 4 cases with middle third gastric cancer using laparoscopic total gastrectomy with Roux-en-Y reconstruction. All cases underwent delta-shaped esophagojejunostomy using modified overlap method. Results All delta-shaped esophagojejunostomy using overlap method was performed successfully. Total operative time was(273.9±; 48.2) min and the time for delta-shaped overlap esophagojejunostomy was (40.9±; 13.3) min. Intraoperative blood loss was (58.9±; 43.4) mL and the mean lymph nodes harvested was 27.1±; 11.8. The microscopic resection margin was cancer-free in all 9 cases. The time to first postoperative flatus and liquid diet was (2.5±; 0.9) d and (4.8±; 1.3) d, respectively. Postoperative hospital stay was (7.9±; 1.8) d. No postoperative complication was found in all cases. Conclusion Delta-shaped esophagojejunostomy using modified overlap method in laparoscopic total gastrectomy and proximal gastrectomy for gastric cancer would be feasible and safe, and deserves clinical practice.

Key words: Gastric cancer, Esophagojejunostomy, Delta-shaped anastomosis, Overlap method