Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2020; 12(1): 21-36
Published online Jan 15, 2020. doi: 10.4251/wjgo.v12.i1.21
Digestive tract reconstruction options after laparoscopic gastrectomy for gastric cancer
Jian Shen, Xiang Ma, Jing Yang, Jian-Ping Zhang
Jian Shen, Xiang Ma, Jian-Ping Zhang, Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
Jing Yang, Cardiovascular Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
Author contributions: Shen J contributed to the study design, literature search, data analysis, and the writing of the manuscript; Ma X contributed to the literature search and data analysis of the study; Yang J contributed to the literature search and sketch drawing; Zhang JP participated in the study design, supervised the study, and wrote the manuscript. All authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare they have no competing financial interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Jian-Ping Zhang, MD, PhD, Professor, Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, No. 121, Jiangjiayuan Road, Nanjing 210011, Jiangsu Province, China.
Received: March 19, 2019
Peer-review started: March 19, 2019
First decision: July 31, 2019
Revised: October 9, 2019
Accepted: November 4, 2019
Article in press: November 4, 2019
Published online: January 15, 2020

In addition to the popularity of laparoscopic gastrectomy (LG), many reconstructive procedures after LG have been reported. Surgical resection and lymphatic dissection determine long-term survival; however, the election of a reconstruction procedure determines the postoperative quality of life for patients with gastric cancer (GC). Presently, no consensus exists regarding the optimal reconstructive procedure. In this review, the current state of digestive tract reconstruction after LG is reviewed. According to the determining influence of the tumor site on the procedures of surgical resection and reconstruction, we divide these reconstruction procedures into three categories consistent with the resection procedures. We focus on the technical tips of every reconstruction procedure and examine the surgical outcomes (length of surgery and blood loss) and postoperative complications (anastomotic leakage and stricture) to facilitate gastrointestinal surgeons to understand the merits and demerits of every reconstruction procedure.

Keywords: Digestive tract reconstruction, Laparoscopic gastrectomy, Gastric cancer, Quality of life

Core tip: This article systematically reviews almost all the reconstruction methods currently used and divides them into three categories according to the method of resection (laparoscopic distal gastrectomy, laparoscopic total gastrectomy, and laparoscopic proximal gastrectomy). This review clearly demonstrates the key steps, merits, and demerits of every reconstruction method via drawing schematics based on the authors’ personal experience.