Objective: To compare the short-term efficacy and quality of life (QOL) between patients undergoing overlap esophagojejunostomy and π-shaped esophagojejunostomy after totally laparoscopic total gastrectomy (TLTG).
Methods: The clinical data of 104 patients with gastric adenocarcinoma meeting the requirements undergoing TLTG from January 2012 to August 2017 were retrospectively collected. Of the patients, 59 cases underwent overlap esophagojejunostomy (overlap anastomosis group) and 45 cases underwent π-shaped esophagojejunostomy (π-shaped anastomosis group). The clinical data and results of QOL questionnaires before and one year after operation were compared between the two groups of patients.
Results: The preoperative data between the two groups were comparable. The average time for anastomosis in π group was significantly shorter than that in overlap group (28.9 min vs. 41.5 min, P<0.05), but the average operative time showed no significant difference between the two groups (287.6 min vs. 315.6 min, P>0.05). There were no statistically differences in terms of intraoperative blood loss, length of incision, postoperative short-term results, and postoperative one-year nutritional status and QOL between the two groups (all P>0.05).
Conclusion: Both overlap and π-shaped esophagojejunostomy after TLTG are safe and feasible. The difference in anastomotic method will not significantly affect the short-term results and QOL of the patients. In clinical practice, the two types of anastomotic methods can be selected according to the specific factors such as the conditions of the patients and the location of the tumor.