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Abstract

Open Roux-en-Y esophagojejunostomy and gastrectomy have long represented a cornerstone in the surgical management of advanced gastric diseases, particularly gastric cancer and benign conditions requiring total gastrectomy. Historically, the procedure evolved from Billroth’s pioneering gastric resections in the late 19th century to the more physiologically favorable Roux-en-Y reconstruction introduced by César Roux in 1893. This technique provides a reliable method for restoring gastrointestinal continuity after total or proximal gastrectomy. The Roux-en-Y configuration minimizes bile reflux, reduces postoperative gastritis, and improves nutritional outcomes compared with earlier reconstruction techniques. Despite the emergence of minimally invasive approaches, open Roux-en-Y reconstruction remains an essential option in complex or extensive disease, allowing direct visualization, precise anastomosis, and effective lymphadenectomy. Its enduring role in surgical practice reflects both its technical reliability and its favorable long-term functional results.

Highlights

This video article presents the step-by-step technique of open total gastrectomy with Roux-en-Y esophagojejunostomy, highlighting essential operative principles, reconstructive strategy, and technical considerations. The accompanying review summarizes current evidence supporting its safety, functional outcomes, and role as the preferred reconstructive approach.

References

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History

Receive Date: 17 July 2025

Revise Date: 03 September 2025

Accept Date: 28 September 2025

Publish Date: 18 October 2025

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