Comparative Study of Totally Laparoscopic and Laparoscopic Assisted Distal Gastrectomy on Lymph Node Dissection Surgical Status Inflammatory Factor and Prognosis
GAO Zihao, ZHANG Chenggong, DING Fan, et al
Huai'an First Hospital, Nanjing Medical University, Jiangsu Huai'an 223300, China
Abstract：Objective: To observe the effects of totally laparoscopic distal gastrectomy (TLDG) and laparoscopic assisted distal gastrectomy (LADG) on lymph node dissection, surgical status, inflammatory factor levels, and prognosis in patients with gastric cancer. Methods: A total of 102 gastric cancer patients from January 2020 to August 2024 were retrospectively selected and divided into TLDG group and LADG group with 51 cases in each group according to different surgical methods. Lymph node dissection, surgical situation, inflammatory factors, and prognosis were compared between the two groups. Results: There were no statistically significant differences in the total number of lymph nodes cleared and the number of positive lymph nodes between the two groups (P>0.05). The length of the main incision and length of postoperative hospital stay in TLDG group were shorter than those in LADG group, and the time for anastomosis was longer than that in LADG group, with statistically significant differences (P<0.05). 24h after surgery, the differences in C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) before and after surgery were smaller in TLDG group than in LADG group, with statistically significant differences (P<0.05). The patients were followed up for 4~59 months. There were 7 and 5 deaths in TLDG group and LADG group, respectively, due to tumor related events. The cumulative survival rates were 73.00% and 78.10%, respectively. There was no statistically significant difference in survival curve between the two groups (P>0.05). Conclusion: TLDG and LADG are both effective treatment methods. However, TLDG is better in terms of postoperative recovery, length of main incision, hospital stay, and inflammatory response.
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2025, Vol. 31 
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