Abstract： ObJective To investigate the efficacy of uncutted Roux-en-Y esophngojejunostomy with jejunal pouch (URYJP) after total gastrectomy.Methods Total gastrectomy was performed on 168 patients of gastric cancer,and 3 methods were used for reconstruction: the uncutted Roux-en-Y esophngojejunostomy with a jejunal pouch was performed on 69 patients (group A),Roux-en-Y esophagojejunostomy with the P-type jejunal pouch on 50 patients (group B),and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch on 49 patients (group C).The alimentary tract reconstruction time,morbidity and mortality were compared.The 121 cases that survived for more than 1 year were analyzed for quality of life (QOL),including body weight,intake quantity,prognosis nutritional index (PNI),and Visick scores 6 and 12 months after the operations.Results All the patients recovered quickly and no anastomosis leakage or duodenal fistulas were found.It took (30±7) minutes to finish the reconstruction in group A,which was significantly shorter than that in group B [(57±6)minutes] or in group C [ (48±6) minutes].There were no significant differences among 3 groups in the incidence of alkaline reflux gastritis. The incidence of Roux stasis syndrome was 2.2% in group A, which was significantly lower than 17.9% and 19.4% in group B and C. Weight lees and food intake gain in group A was superior to those in group B and C 6 months and 12 months postoperatively.As compared with prognosis nutritional index (PNI) postoperatively,those of 3 groups decreased significantly 6 months postoperative]),. At 12 months after operation, the PNI of group A returned to the level before operation, while PNI of both group B and C remained significantly lower than those before operation (beth P ＜ 0.05). The Visick score of group A was superior to those of group B and C 6 months and 12 months postoperatively. Conclusions The new uncutted Roux operation with jejunal pouch can prevent alkaline reflux gastritis and Roux-en-Y stasis syndrome. It may be a standard procedure for reconstruction after total gastrectomy.