Comparison Of Short-Term Outcomes Of Laparoscopy-Assisted And Totally Laparoscopic Distal Gastrectomy For Gastric Cancer

Background/Aims:Laparoscopic gastrectomy has been adopted for the treatment of gastric cancer.Despite the technical difficulties,totally laparoscopic distal gastrectomy has been considered less invasive than laparoscopy-assisted distal gastrectomy.The purpose of this study is to try to assess the feasibility and safety of laparoscopic distal gastrectomy through the analysis of short-term outcomes of totally laparoscopic distal gastrectomy compared with laparoscopy-assisted distal gastrectomy.Materials and Methods:The seventy-five patients who underwent laparoscopic dital gastrectomy in our institution between August 2015 and April 2018 were enrolled in this study.A total of 46 laparoscopy-assisted distal gastrectomy cases and 29 totally laparoscopic distal gastrectomy cases were included.Results:The two groups were comparable in demographic characteristics.The operation time was significantly longer in the totally laparoscopic distal gastrectomy group,while length of wound was shorter in the totally laparoscopic distal gastrectomy group.The totally laparoscopic distal gastrectomy group had a shorter time to first flatus(3.3 days vs.3.7 days,P = 0.034).Estimated blood loss,first flatus,extraction of gastric tube,drainage tube removal,postoperative hospital stay and surgical complications did not show significant differences.White blood cell count at postoperative day 1 in the totally laparoscopic distal gastrectomy group were significantly lower than those in the laparoscopy-assisted distal gastrectomy group.While CRP level at postoperative day 1 in the totally laparoscopic distal gastrectomy group were lower than those in the laparoscopy-assisted distal gastrectomy group,but there is no statistical difference.Conclusions:Our study shows that totally laparoscopic distal gastrectomy is safety and feasible.The short-term outcomes of totally laparoscopic distal gastrectomy revealed better than that of laparoscopy-assisted distal gastrectomy in this study.Prospective and randomized control studies are warranted.