Surg Endosc. 2014 Apr;28(4):1250-5. doi: 10.1007/s00464-013-3315-7.
Totally laparoscopic distal gastrectomy (TLDG) with intracorporeal anastomosis has been introduced to achieve safer anastomosis with good vision, and a small wound. However, little is known about the surgical outcomes of newly introduced TLDG compared with established procedures of laparoscopy-assisted gastrectomy (LADG) with extracorporeal anastomosis.
This retrospective study included 114 patients who underwent laparoscopic distal gastrectomy (LDG) between January 2010 and September 2012. The patients were classified into two groups according to the approach of reconstruction (LADG group: n = 74; TLDG group: n = 40). The parameters analyzed included patients, operation details, and operative outcomes.
No complication was observed in the TLDG group. Surgical outcomes of the TLDG group, such as mean operation time, estimated blood loss, and rate of conversion to laparotomy were not inferior to the LADG group. Furthermore, postoperative hospital stay of the TLDG group was significantly shorter than the LADG group (p < 0.05).
Surgical outcomes in the newly introduced phase of TLDG were safe as well as feasible compared with established LADG. TLDG has several advantages over LADG, such as shorter post-hospital stay, no incidence of operative complication, adequate working space, and small wound size. Although prospective, randomized control studies are warranted, we submit that TLDG can be used as a standard procedure for LDG.
全腹腔镜下远端胃切除术（TLDG）联合腔内吻合术的应用，旨在实现更安全的吻合，具有良好的视野和较小的创伤。然而，与传统的腹腔镜辅助胃切除术（LADG）联合体外吻合术相比，新引入的 TLDG 的手术效果知之甚少。
本回顾性研究纳入了 2010 年 1 月至 2012 年 9 月期间接受腹腔镜远端胃切除术（LDG）的 114 例患者。根据重建方法将患者分为两组：LADG 组（n = 74）和 TLDG 组（n = 40）。分析的参数包括患者、手术细节和手术结果。
TLDG 组无并发症发生。TLDG 组的手术结果，如平均手术时间、估计出血量和中转开腹率，与 LADG 组相当。此外，TLDG 组的术后住院时间明显短于 LADG 组（p < 0.05）。
与已确立的 LADG 相比，新引入的 TLDG 阶段的手术结果是安全可行的。TLDG 相对于 LADG 具有几个优势，如术后住院时间更短、无手术并发症、充足的手术空间和较小的手术切口。虽然需要前瞻性、随机对照研究来证实，但我们认为 TLDG 可以作为 LDG 的标准手术方法。
