Clinical Research Directory

Inclusion Criteria: * Histologically confirmed EGJ type II adenocarcinoma ··The tumor can be removed by laparoscopy through the gastrodiaphragmatic esophageal hiatus or by endoscopic Ivor Lewis operation * Pretreatment stage CT1-4A, N0-3, M0 * For cT4a stage patients, their resectable properties must be clearly verified before randomization * For locally advanced tumors (CT3-T4 or N+), all 4 cycles of chemotherapy (FLOT) were completed before surgery. * 18 to 75 years old * ECOG score 0-2 * ASA \<4 * Good bone marrow function (leukocyte \> x 10 \^ 9 / l; Hemoglobin\> 9 g/dl. ·Platelet\>100×10\^9/ L), renal function (glomerular filtration rate \& GT; 60ml/min) and liver function (total bilirubin \&lt; 1.5 times normal (ULN), aspartate aminotransferase (AST\< 2.5x ULN, Alanine aminotransferase (ALT)\<3 x ULN) * Patients and their family members voluntarily sign written informed consent Exclusion Criteria: * Histologically confirmed EGJ type I and III adenocarcinoma * Tumor spread over 5 cm proximal to EGJ * Clinically significant (active) heart disease (i.e. symptomatic coronary artery disease or myocardial infarction within the last 12 months) resulting in left ventricular ejection fraction\<50%(determined by echocardiography) * Clinically significant lung diseases (forced expiratory volume in 1 second (FEV1)\<1.5 l/s) * Pregnant women and nursing mothers * Stump gastric cancer * Borrmann Type 4 (Leather stomach) * Simultaneous or heterochronous malignant tumors of other organs except carcinoma in situ of the cervix and adenoma and focal colorectal carcinoma * Right thoracotomy or history of right pleural adhesion * Cirrhosis, or indocyanine green test ≥15% of chronic liver disease * No seizure control, central nervous system diseases or mental disorders * History of upper abdominal surgery (except laparoscopic cholecystectomy) * The patient has coagulation dysfunction and cannot be corrected * Patients with heart, lung, liver, brain, kidney and other important organ failure * Patients with metabolic diseases such as diabetes * Immunosuppressive therapy, such as organ transplantation, SLE, etc * Seriously out of control recurrent infections or other seriously out of control concomitant diseases * Other diseases requiring simultaneous surgery * Diseases requiring emergency surgery due to tumor emergencies (e.g. hemorrhage, perforation, obstruction)