Hot issues and rational reflection on digestive tract reconstruction after totally laparoscopic total gastrectomy

The safety and standardization in the technical evolution of totally laparoscopic total gastrectomy are yet to be established. Clinical researches and technical innovations have laid a solid foundation for the maturity of totally laparosco pic total gastrectomy for the patients with advanced gastric cancer.In the view of the author, focus issues of digestive tract reconstruction after totally laparoscopic total gastrectomy include D₂、D₂₊lymph node dissection technology (splenic lymph node dissection, lower mediastinal lymph node dissection, abdominal para aortic lymph node dissection), rational selection of digestive tract reconstruction methods with anti-reflux effect, food storage capacity and the best quality of life, and safe anastomosis or suture technique of esophagojejunostomy.