To evaluate the feasibility and safety of multipoint fixed-overlap (MF-Overlap) in esophagojejunostomy after totally laparoscopic total gastrectomy (TLTG).

The clinical and pathological data of 64 gastric cancer patients with TLTG treated in the Department of Surgery, the Fourth Hospital of Hebei Medical University from December 2020 to July 2021 were retrospectively analyzed. According to different digestive tract reconstruction methods, the patients were divided into the traditional Overlap group (35 cases) and the MF-Overlap group (29 cases), and the operation and postoperative recovery were compared between the two groups.

All 64 patients successfully completed TLTG, with no conversion to open surgery or perioperative death. Compared with the traditional Overlap group, the total operation time of MF-Overlap group [(255.5±5.6) min vs (271.2±3.3) min, t=-3.358, P=0.012], esophageal-jejunal anastomosis time [(42.1±3.1) min vs (53.1±5.6) min, t=-6.146, P=0.007], and postoperative hospital stay [(6.6±2.1) d vs (7.8±2.4) d, t=-3.256, P=0.003] were significantly shortened, and the incidence of anastomotic complications (0 vs 20.00%, χ²=6.513, P=0.011) was significantly decreased. There were no significant differences in intraoperative blood loss, the number of lymph node dissection, intestinal recovery time and other postoperative complications between the two groups.

Compared with the traditional Overlap method, MF-Overlap can simplify the anastomosis process, shorten the operation time, and is safe and feasible for esophageal-jejunal anastomosis after TLTG with satisfactory curative effect.