Application of Modified π-Shaped Anastomosis in Digestive Tract Reconstruction during Totally Laparoscopic Total Gastrectomy

Objective To investigate the feasibility and short-term efficacy of the modified π-shaped anastomosis technique for esophagogastric anastomosis in gastrointestinal reconstruction after total gastrectomy performed entirely by laparoscopy. Methods This study included 50 patients who underwent totally laparoscopic gastrectomy with modified π-shaped anastomosis for gastrointestinal reconstruction at the First Affiliated Hospital of Wannan Medical College from August 2021 to August 2023. In this study, intraoperative and postoperative indicators were measured to assess the feasibility and short-term efficacy of this technique. Our modified surgical approach involved first resecting the jejunal mesentery and dividing the jejunum during gastrointestinal tract reconstruction, followed by esophagojejunal anastomosis. Results All 20 patients successfully underwent surgery; the operation time was 2–3 hours, and the esophagogastric anastomosis time, postoperative hospital stay, time to first postoperative ventilation, and time to first postoperative feeding. No complications such as intestinal obstruction, anastomotic bleeding, anastomotic fistula, or anastomotic stenosis were observed. All 20 patients were followed up for more than one year, with no evidence of long-term complications or recurrence. Conclusion Modified π-shaped anastomosis is effective for digestive tract reconstruction during totally laparoscopic total gastrectomy (TLTG), thereby effectively preventing mucosal eversion, reducing anastomotic tension, and decreasing the incidence of anastomotic leakage.