Analysis Of Short-term Clinical Efficacy Of Totally Laparoscopic Distal Radical Gastrectomy

Objective: To investigate the radical,safety, feasibility and application advantages of totally laparoscopic distal gastrectomy.Methods: A retrospective analysis of clinical data of patients who underwent gastrectomy in our Gastrointestinal Cancer Surgery Department from October 2013 to October 2015 was performed; According to the inclusion and exclusion criterias, study enrolled 97 patients. And it divided them into three groups by different surgical methods: Totally laparoscopic distal gastrectomy(TLDG) group(22 cases), LADG(laparoscopy-assisted distal gastrectomy) group(35 cases), and ODG(open radical distal gastrectomy)group(40cases).Then several materials such as intraoperative situation, postoperative recovery, radical resection of tumor and postoperative complications were compared.Results: There were no significant differences in the number of lymph nodes dissection, the length of proximal and distal margin, blood loss, postoperative defecation time, resume time and postoperative complication rate(P> 0.05). However, in the three groups, the incision length of TLDG is the minimum(4(3.5-4.5) cm) followed by LADG group(7(7-7) cm), and ODG group is up to 14(13.5-14) cm. Then the twenty-two multiple comparisons were statistically significant(P <0.01). What's more, it showed that the postoperative exhaust time in TLDG group is 3.5(3-4) d which is shortet than 4(3-5) d in ODG group(P = 0.03). And the postoperative hospital stay of TLDG was 12(10-13) d while the longer postoperative hospital stay was 13(12-15. 75) d in ODG group(P = 0.049). Moreover the operative time in ODG group is shorter than TLDG group and LADG group(P<0.05). They were(173.0 ± 42.4) min,(195.9 ± 30.0)min and(209.1 ± 40.5) min respectively.Conclusion: Considering the principle of radical tumor resection, totally Laparoscopic distal gastrectomy is feasible and security. Without increasing blood loss and postoperative complication rates, it showed shorter incision, faster recovery after surgery and better minimal invasion.