Application of self-pulling and latter transection in totally laparoscopic total gastrectomy.

[BACKGROUND] Recent years have seen an increase in gastric cancer incidence. The most effective method of treating gastric cancer is still surgical resection. Over the past few decades, minimally invasive surgery has rapidly developed, reducing post-operative complications and speeding up recovery. However, the technical difficulties, especially during anastomosis, hinder the widespread use of this advanced surgery. The aim of this study was to investigate the safety and efficacy of self-pulling and latter transection in totally laparoscopic total gastrectomy (SPLT-TLTG).

[PATIENTS AND METHODS] A retrospective study compared the outcomes of laparoscopic-assisted total gastrectomy (LATG) and SPLT-TLTG in patients with gastric cancer. Eighty patients who underwent either LATG or SPLT-TLTG between January 2016 and June 2018 were included in the study. Clinical information was used to compare patients who underwent these surgeries.

[RESULTS] Compared to LATG, patients who received SPLT-TLTG surgery recovered faster than those who received LATG time (operation and digestive tract reconstruction), blood loss, rehabilitation, first flatus, oral food intake, average pain score and hospital stay were significantly shorter in the SPLT-TLTG group than in the LATG group ( P < 0.05). However, the two groups had no significant differences in LNs and baseline characteristics.

[CONCLUSIONS] The findings of this study provide significant evidence in support of the use of self-pulling and the latter transection procedures in total laparoscopic gastrectomy.