To investigate the clinical effect of Overlap tube gastroesophageal anastomosis with laparoscopic assistance in Siewert typeⅡ and Ⅲ esophagogastric junction adenocarcinoma (AEG).

The clinical data of 30 patients with Siewert type Ⅱ and type Ⅲ AEG who underwent laparoscopic-assisted proximal gastrectomy from Jan. 2018 to Apr. 2020 in the Gastrointestinal Center, Subei People′s Hospital of Jiangsu Province were retrospectively analyzed. Among them, 18 cases of traditional esophagogastric anastomosis (group A) were performed before May 2019, and 12 cases of Overlap tube gastroesophageal anastomosis (group B) were performed in May 2019 and after. SPSS 19.0 statistical software was used for analysis. Measurement data such as general patient data, perioperative indicators and postoperative reflux questionnaire (RDQ) scores were expressed as ±s, and pairwise comparisons were performed by t test; postoperative gastroesophagus reflux disease (GERD), reflux esophagitis (RE) and other counting indicators were compared using the χ² test, and P<0.05 was considered statistically significant.

The RDQ scores of the traditional group and the tube stomach group were (13.83±5.09) points vs (9.08±3.63) points and (13.16±4.97) points vs (8.67±3.68) points at 1 month and 3 months after operation. The number of GERD diagnosed in the two groups at 1 month and 3 months after operation were (9 cases vs 2 cases) and (10 cases vs 2 cases). Gastroscopy confirmed that there were 7 cases of RE in the traditional group and 1 case in the tube-gastric group. Postoperative RDQ scores of patients in the tube-gastric group were lower than those in the traditional group, and the difference was statistically significant (P<0.05). In the comparison of postoperative RE and GERD incidence, the tube-gastric group was significantly lower than the traditional group, but the difference between the two groups was not statistically significant (P>0.05).

Compared with traditional gastroesophageal anastomosis, the Overlap tube gastroesophageal anastomosis with laparoscopic-assisted has a better effect on anti-reflux after surgery, and the traumat is relatively small, the operation is simple and safe, and it is worthy of clinical promotion.