| Purpose: This study aimed to compare the short-term surgical outcomes following totally laparoscopic distal gastrectomy with D2 lymphnode dissection(TLDG)and laparoscopy-assisted distal gastrectomy with D2 lymphnode dissection(LADG)which underwent Uncut Roux-en-Y reconstruction for the treatment of gastric cancer.Methods: 73 patients with gastric cancer who underwent laparoscopic distal gastrectomy with D2 lymphnode dissection(LDG)in the first affiliated hospital of fujian medical university between June 2014 to September 2016 were reviewed retrospectively,all the patients were received Uncut Roux-en-Y reconstruction.The patients were classified into two groups based on the surgical procedures:35(47.9%)patients who received totally laparoscopic distal gastrectomy(TLDG) and 38(52.1%)patients who received laparoscopy-assisted distal gastrectomy(LADG).Patients demographics,intraoperative variables and Short-term surgical outcomes were compared between the groups.Results: All procedures were completed successfully.There was no difference in gender,mean age,body mass index,comorbidity,anesthesia grade,lymph node metastasis and tumor characteristics between the groups.Operating time was longer for TLDGthan for LADG,(212.54±26.50)min vs(191.21±18.03)min,(P<0.05).Blood loss during surgery in TADGgroupwas significantly less than LADG groups,(42.60±9.06)ml vs(70.29±11.88)ml,(P<0.05).The length of the incision in the TLDG group was shorter than in the LADG group,(2.99±0.34)cm vs(6.61±0.37)cm,(P<0.05)。Patients in the TLDG group were able to get out of bed early compared with the LADG group,(19.49±2.16)h vs(25.29±3.59)h,(P<0.05),and in the TLDG group,the level of Serum C-reactive protein was lower on the first postoperative day(P<0.05),and there were no significant differences between the two groups on days 3,5,and before discharge.The patients in the TLDG group had a significantly shorter postoperative hospital stay(P<0.05).It was found that the postoperative pain score in the patients underwent TLDG were significantly lower than those underwent LADG in the first three days after surgery(P<0.05).The median total Hospital costs(RMB)were greater in the TLDG group than in the LADG group(P<0.05),There were no significant differences in the number of lymph nodes dissected,the length of the proximal and distal margin of the tumor and complications.One patient in the LADG group had an incision infection after surgery.There was no anastomotic leakage,anastomotic stenosis or anastomotic bleeding and other complications related to anastomosis.Conclusions: TLDG and LADG with Uncut Roux-en-Y reconstruction have the same safety and feasibility,in addition,totally laparoscopic distal gastrectomy with Uncut Roux-en-Y reconstruction is associated with minimal trauma,less blood,quicker postoperative recovery,shorter postoperative hospital stay and slighter pain in the short-term recovery after surgery. |
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