A Prospective Study on Esophagogastrostomy by an Innovative Surgical Technique

Inclusion criteria

• Age between 18 and 75 years old;
• Pathologically confirmed as adenocarcinoma;
• Primary tumor located in the upper 1/3 of the stomach or the gastroesophageal junction (Siewert II or III);
• If it is adenocarcinoma of the upper 1/3 of the stomach, cT1N0M0 should be met.
• For gastroesophageal junction adenocarcinoma, cT1-2N0M0 should be met, and clinical judgment should indicate no distant lymph node metastasis around the stomach.
• Bilateral resection margins should be greater than 2 cm, and more than half of the residual stomach should be preserved.
• No history of upper abdominal surgery (excluding laparoscopic cholecystectomy).
• No preoperative comprehensive treatments such as chemotherapy, radiotherapy, targeted therapy, immunotherapy, etc.
• Preoperative ECOG (Eastern Cooperative Oncology Group) score of 0/1.
• Preoperative ASA (American Society of Anesthesiologists) score I-III.
• Good function of important organs.
• Signed informed consent.

Exclusion criteria

• Preoperative assessment indicating cT4b or Bulky lymph nodes enlargement or distant lymph nodes metastasis;
• Pregnant or lactating women;
• Patients with severe mental illness;
• Preoperative temperature ≥38°C or infectious diseases requiring systemic treatment;
• Severe respiratory diseases, with FEV1 < 50% of predicted value;
• History of other malignant tumors in the past 5 years;
• Severe liver or kidney dysfunction;
• Unstable angina or myocardial infarction within the last 6 months;
• History of stroke or cerebral hemorrhage within the last 6 months (excluding old infarcts);
• Systemic use of glucocorticoids within the last 1 month;
• Emergency surgery required due to complications of gastric cancer (bleeding, perforation, obstruction);
• Patient has participated in or is currently participating in other clinical trials (within the last 6 months).