摘要Objective:To explore the change and feasibility of surgical techniques of laparoscopic transhiatal(TH)-lower mediastinal lymph node dissection(LMLND)for adenocarcinoma of the esophagogastric junction(AEG)according to Idea,Development,Exploration,Assessment,and Long-term follow-up(IDEAL)2a standards.Methods:Patients diagnosed with AEG who underwent laparoscopic TH-LMLND were prospectively included from April 14,2020,to March 26,2021.Clinical and pathological information as well as surgical outcomes were quantitatively analyzed.Semistructured interviews with the surgeon after each operation were qualitatively analyzed.Results:Thirty-five patients were included.There were no cases of transition to open surgery,but three cases involved combination with transthoracic surgery.In qualitative analysis,108 items under three main themes were detected:explosion,dissection,and reconstruction.Revised instruction was subsequently designed according to the change in surgical technique and the cognitive process behind it.Three patients had anastomotic leaks postoperatively,with one classified as Clavien-Dindo Ⅲa.Conclusions:The surgical technique of laparoscopic TH-LMLND is stable and feasible;further IDEAL 2b research is warranted.