Comparison of outcomes between totally laparoscopic total gastrectomy and laparoscopic-assisted total gastrectomy for gastric cancer: A retrospective cohort study

INTRODUCTION: To compare the efficacy and safety between totally laparoscopic total gastrectomy (TLTG) and laparoscopic-assisted total gastrectomy (LATG) with D2 lymph node dissection.
METHODS: This was a retrospective cohort study comparing patients who underwent TLTG
(group 1) and LATG with D2 lymph node dissection (group 2) between 01/2012 to 03/2020.
RESULTS: 59 patients in the TLTG group and 36 patients in the LATG group with D2 lymph node dissection were included in the analysis. All cases in both groups showed no microscopic tumor cells on the proximal and distal resection margins (R0). Postoperative complications were lower in the TLTG group than in the LATG group (p<0.05). There was no death during or after the surgery. The number of harvested lymph nodes in the TLTG group was higher than in the LATG group (p<0.05). The operation time, gastric tube removal time, first flatus time, drain removal time, diet time, and hospital stay time in the TLTG group were shorter than the LATG group (p<0.05). The mean postoperative survival times of the patients in both groups were insignificantly different (p>0.05).
DISCUSSION AND CONCLUSION: TLTG and LATG with D2 lymph node dissection were safe and effective inr the treatment of gastric cancer. However, the TLTG had more benefits over LATG, as patients had less pain, and shorter intensive care, recovery, operative, hospital stay time. The surgical site by TLTH was also smaller than LATG.