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Lymph node dissection in <jats:styled-content style=\"fixed-case\">LTG<\/jats:styled-content> is technically similar to that in laparoscopic distal gastrectomy for early gastric cancer; however, <jats:styled-content style=\"fixed-case\">LTG<\/jats:styled-content> for advanced gastric cancer requires extended lymph node dissections including splenic hilar lymph nodes. Although a recent randomized controlled trial clearly indicated no survival benefit in prophylactic splenectomy for lymph node dissection at the splenic hilum, some patients may receive prognostic benefit from adequate splenic hilar lymph node dissection. Considering reconstruction, there are two major esophagojejunostomy (<jats:styled-content style=\"fixed-case\">EJS<\/jats:styled-content>) techniques, using a circular stapler (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>) or using a linear stapler (<jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>). A few studies have shown that the <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> method has fewer complications; however, almost all studies have reported that morbidity (such as anastomotic leakage and stricture) is not significantly different for the two methods. As for <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>, we grouped various studies addressing complications in <jats:styled-content style=\"fixed-case\">LTG<\/jats:styled-content> into categories according to the insertion procedure of the anvil and the insertion site in the abdominal wall for the <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>. We compared the rate of complications, particularly for leakage and stricture. The rate of anastomotic leakage and stricture was the lowest when inserting the <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> from the upper left abdomen and was significantly the highest when inserting the <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> from the midline umbilical. Scrupulous attention to <jats:styled-content style=\"fixed-case\">EJS<\/jats:styled-content> techniques is required by surgeons with a clear understanding of the advantages and disadvantages of each anastomotic device and approach.<\/jats:p>","DOI":"10.1002\/ags3.12208","type":"journal-article","created":{"date-parts":[[2018,9,17]],"date-time":"2018-09-17T13:34:14Z","timestamp":1537191254000},"page":"14-23","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Current status of laparoscopic total gastrectomy"],"prefix":"10.1002","volume":"3","author":[{"given":"Yoshihiko","family":"Kawaguchi","sequence":"first","affiliation":[{"name":"First Department of Surgery Faculty of Medicine University of Yamanashi Chuo Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"First Department of Surgery Faculty of Medicine 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