To study the clinical efficacy of laparoscopic-assisted proximal gastrectomy for three different digestive tract reconstruction methods in the treatment of Siewert Ⅱ and Siewert Ⅲ esophagogastric junction adenocarcinoma (AEG).

A retrospective analysis of the data of 93 Siewert type Ⅱ and Siewert type Ⅲ AEG patients admitted to the Subei People’s Hospital of Jiangsu Province from Jan. 2016 to Dec. 2018. Divided into three groups according to different ways of digestive tract reconstruction. Among them, 31 esophagogastrostomy (group A), 33 double tract reconstruction (group B)and 29 single-canal jejunum interposition (group C). Data analysis was performed using SPSS 19.0 software. The perioperative indicators were showed by ( ±s). The measurement data comparison between the three groups was analyzed by single factor analysis of variance. The pairwise comparison between groups was performed by t test. The incidence of postoperative complications was measured by χ² test. P<0.05 was considered statistically significant.

The three groups of patients successfully completed the operation without perioperative deaths. The operation time of group B and C was longer than that of group A (P<0.05). Compared with postoperative short-term nutritional status (total serum protein, serum albumin, hemoglobin), group B and C were better than group A (P<0.05). The incidences of reflux esophagitis(RE) were 35.5%, 3.0%, and 0.0%, respectively, and the differences were statistically significant (P<0.05).

Laparoscopic-assisted proximal gastrectomy in patients with AEG undergoing jejunal interposition (double tract reconstruction, single-canal jejunum interposition) has better short-term postoperative nutritional status and fewer postoperative complications than traditional esophagogastrostomy, especially in terms of RE, jejunal interposition has obvious advantages, which is an ideal way to reconstruct the digestive tract in patients with AEG undergoing proximal gastrectomy.