Comparison of the safety of esophagojejunal overlap and π-shaped anastomosis in totally laparoscopic total gastrectomy.

[BACKGROUND] Globally, totally laparoscopic total gastrectomy is increasingly being accepted by surgeons for the treatment of gastric cancer. Overlap anastomosis and π-shaped anastomosis are the two most commonly used anastomosis methods in total laparoscopic surgery; however, their safety and suitability for the population are still unclear.

[METHODS] A total of 162 consecutive patients with gastric cancer who underwent total laparoscopic total gastrectomy with overlap or π-shaped anastomosis were retrospectively analyzed. The intraoperative conditions and postoperative complications were compared.

[RESULTS] A significant difference in the tumor location was found between the two groups (p < 0.05). No significant difference was found in the operation time, intraoperative blood loss, and postoperative hospital stay between the two anastomosis methods (p > 0.05); however, the π-shaped anastomosis group had more postoperative anastomotic leakage (p < 0.05).

[CONCLUSIONS] Overlap anastomosis is recommended as the preferred anastomosis for totally laparoscopic total gastrectomy, and π-shaped anastomosis can be applied to non-gastroesophageal junction cancer with lower tumor location.