Short Term Efficacy Evaluation And Safety Analysis Of Total Laparoscopic Radical Gastrectomy For Gastric Cancer

Objective:To evaluate the short-term efficacy and safety of total laparoscopic radical gastrectomy(TLG)in patients with gastric cancer.Methods:296 patients with gastric cancer hospitalized in the Anhui Provincial Hospital from January 1,2019 to December 31,2020 were retrospectively analyzed.They were divided into total laparoscopic group(TLG group)and laparoscopic assisted group(LAG group)according to whether they underwent intraperitoneal gastrointestinal reconstruction;Compare the clinical data of the two groups of patients.Results:Among 296 patients with gastric cancer,140 patients were included in TLG group and 156 patients in LAG group.There was no significant difference in preoperative baseline data such as gender,age and BMI between the two groups(P>0.05).Compared with LAG group,TLG group had shorter operation time [220(54)vs 240(70),P=0.001],less intraoperative bleeding [85(50)vs 100(50),P=0.002] and smaller incision[5(2)vs 8(1),P<0.001].In addition,the leukocyte value on the first day after operation [11.68(3.21)vs 13.90(4.92),P<0.001],postoperative ventilation time[3(1)vs4(2),P<0.001]and postoperative hospital stay[8(2)vs 9(3),P<0.001] in TLG group were shorter than those in LAG group.The pain scores of patients in LTG group were significantly lower than those in LAG group on the 1st and 3rd day after operation(all P<0.05).There was no significant difference between the two groups in the distance between the distal and proximal tumor margins [proximal 2.30(1.50)vs2.00(2.00),P=0.07,distal 6.00(3.88)vs6.00(3.00),P=0.06],the number of lymph nodes cleaned [23(11)vs22(10),P=0.41] and TNM staging [61/27/52 vs 55/39/62,P=0.29].There was no significant difference in the incidence of postoperative complications between TLG group(5.71%)and LAG group(7.69%)(P>0.05).Subgroup analysis of whether total gastrectomy or distal gastrectomy was performed;Similarly,compared with endoscopic assisted total gastrectomy(LATG)or assisted distal gastrectomy(LADG),patients in the total endoscopic total gastrectomy(TLTG)or total endoscopic distal gastrectomy(TLDG)group had shorter operation time,less bleeding,less postoperative pain,and shorter ventilation time,fluid intake time,and postoperative hospital stay.Conclusion:total laparoscopic radical gastrectomy for gastric cancer has faster postoperative recovery.It can achieve the effect of radical gastrectomy without increasing the risk of postoperative complications.It has the advantages of small trauma,safety and feasibility,and is worthy of promotion.