Feasibility, Safety And Short-term Efficacy Of Totally Laparoscopic Total Gastrectomy For Upper Stomach Cancer

Objective To investigate the clinical value of totally laparoscopic total gastrectomy in treatment of cancer of the upper stomach.Methods The clinical data of 66 patients with cancer of the upper stomach undergoing laparoscopic total gastrectomy from May 2013 to September 2014 were retrospectively analyzed.Of the patients,16 cases underwent totally laparoscopic total gastrectomy (total-laparopic group) and 50 cases were subjected to laparoscopically-assisted total gastrectomy (laparoscopic-assisted group).The preoperative data,intraoperative variables,and postoperative conditions between the two groups of patients were compared.Results The preoperative data between the two groups were comparable.In total-laparoscopic group compared with laparoscopic-assisted group,the operative time was prolonged,and hospitalization cost was increased(both P<0.05),but it was superior in respects of the length of surgical incision,postoperative pain,time for postoperative recovery,length of postoperative hospital stay and incidence of postoperative complications(all P<0.05).There was no significant difference in intraoperative blood loss,distance from proximal and distal margins of resection,and number of lymph nodes dissected between the two groups(all P>0.05).Conclusion Totally laparoscopic total gastrectomy is safe and feasible,which provides a treatment choice for gastric cancer and a future direction for the development of the concept of minimal invasiveness.