Abstract: Objective To evaluate the clinical value of transumbilical gastric conduit formation in esophagectomy compared with conventional open abdominal approach. Methods We retrospectively analyzed 102 patients who underwent radical esophagectomy for esophageal cancer at our hospital between January 2024 and January 2025. According to different surgical approaches, the patients were divided into a transumbilical group and a conventional open approach group （51 patients in each group）. Operative parameters including surgical duration, intraoperative blood loss, lymph node yield, postoperative pain scores, postoperative recovery, and complication rates were compared between the two groups. Results The transumbilical group demonstrated significantly reduced intraoperative blood loss, lower postoperative pain scores, shorter time to first flatus, and reduced length of hospital stay compared to the conventional open approach group （P<0.05）. No significant difference was observed in the total number of harvested lymph nodes between the two groups （P>0.05）. The transumbilical group exhibited a significantly lower incidence of incision-related complications than the conventional open approach group （P<0.05）. There was no statistically significant difference in the incidence of other complications such as anastomotic leakage, pulmonary infection, and chylous leakage between the two groups （P>0.05）. Conclusion Compared with conventional open abdominal gastric conduit formation, the transumbilical approach offers significant advantages including reduced surgical trauma, accelerated postoperative recovery, and lower complication rates, without compromising lymph node dissection adequacy or increasing anastomotic complications. This approach represents a safe and effective option for esophagectomy.

Key words: Esophageal carcinoma, Transumbilical, Gastric conduit formation, Open surgery, Comparative study