Abstract:Objective：To study the optimal procedure of digestive tract reconstruction after total gastrectomy. Methods：The clinical data of 122 patients who underwent total gastrectomy in the recent 6 years were analyzed retrospectively. Three types of reconstruction procedures, including Orr-type Roux-en-Y esophagojejunostomy, P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy, were performed. Results：There were no significant differences among the three procedures in heartburn and the amount of food intake, frequencies of meal, weight loss, dumping syndrome, and hemoglobin and albumin levels. The operation time in P-type group was longer than the other two group(P<0.05).The size of pouch and pouch emptying function in aboral pouch group were significantly superior to the other groups. Conclusions：Distal jejunal aboral pouch Roux-en-Y esophagojejunostomy can be recommended as a new procedure for digestive reconstruction after total gastrectomy.