Comparison of Clinical Effects between Modified and Conventional Delta-Shaped Anastomosis in Totally Laparoscopic Distal Gastrectomy: A Retrospective Study.

This study evaluates the feasibility, safety, and clinical results of the self-pulling and latter transected delta-shaped anastomosis (Delta SPLT) in totally laparoscopic distal gastrectomy (TLDG) for gastric cancer. We performed a retrospective study of 66 patients with gastric cancer undergoing laparoscopic distal gastrectomy with Billroth-I anastomosis from May 2017 to December 2018 in Zhoushan Hospital. TLDG with Delta SPLT was carried out in 26 patients (Group 1), and TLDG with conventional delta-shaped anastomosis (DA) was performed in 40 patients (Group 2). Statistical analysis was conducted to compare clinical data between the two groups. All patients successfully underwent TLDG. There were no significant differences between the two groups in terms of demographic indicators, operation time, anastomosis time, intraoperative blood loss, number of lymph nodes harvested, and resection margin (all  > .05). The gastrointestinal functional evaluation index (first flatus, first liquid/semigeneral diet foods, and out-of-bed mobilization) and hospital stay did not differ between the two groups, but the mean hospital charges were significantly lower in Group 1 than in Group 2 ( < .05). No difference was observed in the overall postoperative complication rate ( > .05). However, Group 1 had a lower incidence of complications associated with anastomosis (3.8%, versus 7.5% in Group 2;  = .016). Delta SPLT is potentially a safe, feasible, and reproducible reconstruction option for TLDG, and was superior to conventional DA in terms of hospital charges and complications related to anastomosis.