Development and application of esophageal gastric-tube reconstruction in upper gastrointes-tinal surgery

Gastric cancer and esophageal cancer are the top ranked malignant tumors of the upper gastrointestinal tract in China, and the incidence of adenocarcinoma of esophagogastric junction (AEG) has been on the rise in recent years. Currently, surgery is the main treatment strategy for AEG, but the surgical approach and the path of digestive tract reconstruction are still contro-versial. The digestive tract reconstruction after AEG surgery include traditional total gastrectomy + Roux-en-Y reconstruction or proximal gastrectomy + esophageal gastric-tube reconstruction/double-tract reconstruction/double-flap technique reconstruction. With the development of surgery, esophageal gastric-tube reconstruction has become a common digestive tract reconstruction modality after AEG compared with traditional esophagojejunal reconstruction of total gastrectomy, which can reduce the incidence of postoperative complications such as anastomotic leakage, reflux esophagitis, anasto-motic stricture, and patients' malnutrition in the long term. In order to further reduce postoperative complications, the application of new techniques and improvement of surgical methods have become the focus of research in recent years. The authors review the history of the development of esopha-geal gastric-tube reconstruction and provides an overview of the current status of esophageal gastric-tube reconstruction, reconstruction pathway, anastomotic position and modality, and research on the reduction of postoperative complications.