摘要完全腹腔镜全胃切除术是胃外科技术要求最高的手术，既需要在腹腔镜下完成全胃切除及淋巴结清扫，还需要在腹腔镜下完成消化道重建，其中腹腔镜下食管空肠吻合是技术难点。目前常用的吻合方式包括管状吻合、直线切割吻合以及手工缝合3类，但如何合理、安全选择吻合方式仍存较大争议。笔者结合团队经验，回顾器械吻合和手工缝合的进展，深入阐述在全腹腔镜时代胃外科医师根据个人腔镜技术能力、器械及患者条件选择合适的食管空肠重建方式，力求以最小的创伤达到最佳的精准、微创效果。

abstractsTotally laparoscopic total gastrectomy is the most comlex procedure in gastric surgery, which involves the entire stomach removal, lymph node dissection and digestive tract recons-truction through minimally invasive techniques, among which laparoscopic esophagojejunostomy is a technological difficulty. Currently, three types of anastomoses are widely used, including stapled anastomosis with circular staplers or linear staplers, and hand suturing, but which is the best and safe anastomosis remains controversial. Based on team experience, the authors review the progress of esophagojejunostomy on stapled anastomosis or hand suturing, promote that how to select an appropriate esophagojejunostomy according to surgeon′s individual technical capabilities, operating habits and patient conditions, strive to achieve the precise and minimally invasive effect with the least trauma for patients.