Intracorporeal hand-sewn esophagojejunostomy after totally laparoscopic total gastrectomy

Objective To evaluate the clinical effects of the totally laparoscopic and laparoscopic-assisted radical gastrectomy for gastric cancer, and evaluate the feasibility and safety of the two methods. Methods Eighty patients with gastric cancer undergoing radical D2 gastrectomy from Mar 2016 to Jul 2017 were enrolled. Patients were divided into totally laparoscopically hand-sewn escophagojejunostomy group (35 cases) and control group of hand-assisted laparoscopic esophagojejunostomy (45 cases). Results Compared with the control group, the operation time, blood loss, lymph node dissection in the control group were not significantly different [(256±53)min vs.(248±62)min, t=2.40, P>0.05; (123±78)ml vs. (162±56)ml, t=-1.94, P>0.05; (28±6) vs.(30±7), t=-3.18, P>0.05]. The postoperative ambulation time, first exhaust time, postoperative hospital stay, incision complications were all in favor of the totally laparoscopic group [(1.5±0.7)d vs.(2.6±0.6)d, t=-2.41, P<0.05; (2.7±0.8)d vs.(4.0±1.2)d, t=-4.63, P<0.01; (6.8±0.8)d vs.(9.2±1.6)d, t=-7.32, P<0.05]. Conclusions Totally laparoscopic radical gastrectomy and hand-sewn esophagojejunostomy for gastric cancer is safe and reliable and has advantages such as less pain and fast recovery. Key words: Stomach neoplasms; Anastomosis, surgical; Gastrectomy; Laproscopy