Effect Analysis Of Totally Laparoscopic Radical Gastrectomy(TLRG)for Gastric Cancer

Objective:To investigate the postoperative effect difference between totally la paroscopic radical gastrectomy(TLRG)and laparoscopy-assisted radical gastrectomy(LADG).Analyzing the recanalization and prognosis after the reconstruction of Uncut roux-en-Y for gastric cancer.Methods:We collected the clinical and pathological data of gastric cancer patients which had accepted the laparoscopic radical gastrectomy for gastric cancer from the Second Hospital of Dalian Medical University between May 2015 and August 2016.According to whether completely accomplished the reconstruction of digestive tract in the abdominal cavity,the samples were divided into two groups: totally laparoscopic radical gastrectomy and laparoscopy-assisted radical gastrectomy,compared the statistic difference among the clinical and pathological data.We also divided the samples into the ways reconstruction of Uncut roux-en-Y and Roux-en-Y according the ways of digestive tract reconstruction and analyzed the statistic difference among groups.According to the extent of surgical resection,we divided the samples into two groups: total gastrectomy and distal gastrectomy,compared the statistic difference among the clinical and pathological data.We arrranged for patients which accepted the way of Uncut roux-en Y reconstruction with upper gastrointestinal radiography or gastroscopy 3 to 8 months after operation,evaluating the value of Uncut roux-en-Y reconstruction.We followed-up all the patients and gathered survival time.Used Log-rank to analyze the influence of totally laparoscopic radical gastrectomy and laparoscopy-assisted radical gastrectomy.Results: Compared with laparoscopy-assisted radical gastrectomy(LADG),the intraoperative blood loss of TLRG was less,the number of lymph node diss ection was more,the surgical incision length was smaller,the postoperative feedi ng time was shorter and the medical expenditure was less,the difference was sta tistically significant of them,P value were 0.0043,<0.0001,<0.0001,0.005 and <0.0001,respectively.But there were not statistical difference in the incidence ra te of delayed gastric emptying,anastomotic leakage,hospitalization time and post operative pulmonary infection(P>0.05).According of survival analysis result,the re were also obvious difference between LADG and TLRG(P=0.6840).Compare d with the traditional Roux-en-Y,Uncut roux-en Y reconstruction have shorter op eration time,less intraoperative blood loss,shorter time to recover diet again,an d more medical expenditure than traditional Roux-en-Y reconstruction(P<0.05),th e P value were 0.0017,0.0428,0.0007 and 0.0002,respectively.Conclusions: the TLRG and Uncut roux-en-Y reconstruction were more safe and effective,we should priority choose Uncut roux-en-Y them in operation when the economic factors could be ignored.