Long-term Efficacy Of Total Laparoscopic Radical Distal Gastrectomy With Delta-shaped Anastomosis

Objective To observe the Long-term efficacy of TLDG with delta-shaped anastomosis for distal gastric cancer treatment via a comparison of survival rate with LADG with tubular anastomosis. Methods The clinical and pathologic data of 160 distal gastric cancer patients were retrospectively analyzed in the study, all the cases were operated in LDG with Billroth I anastomosis at The First Affiliated Hospital of Chongqing Medical University from December 2012 to March 2015, 86 of whom underwent TLDG with delta-shaped anastomosis(delta-shaped anastomosis group,DAG) and 74 of whom underwent LADG with extracorporeal gastroduodenostomy using circular staplers(tubular anastomosis group,TAG). A comparison of cumulative survival rate(CSR) between the two groups was performed. Results Postoperative follow-up time of DAG was 7-32 months, follow-up rate was 91%(78/86),the cancer-related deaths was 11, the CSR by the end of the follow-up was 82.8%; Postoperative follow-up time of TAG was 7-33 months, follow-up rate was 95%(70/74), the cancer-related deaths was 7,the CSR by the end of the follow-up was 81.7%; The difference of CSR between the two groups was not significant(c2=1.210,P=0.271).No cancer-related deaths in stage I patients of both groups. The difference of CSR by the end of the follow-up of stage II and stge III(DAG vs. TAG: 87.2% vs. 93.3% and 65.3% vs. 37.6%)was not significant too(c2=0.426 and c2=0.718,P=0.514 and P=0.397). Conclusions The TLDG with delta-shaped anastomosis and LADG with tubular anastomosis have similar long-term efficacy in the treatment of distal gastric cancer.