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Comparison of early-term effects between totally laparoscopic distal gastrectomy with delta-shaped anastomosis and conventional laparoscopic-assisted distal gastrectomy: a retrospective study.

OBJECTIVE
To compare early-term effects of totally laparoscopic distal gastrectomy with delta-shaped anastomosis (D-STLDG) with conventional laparoscopic-assisted distal gastrectomy (LADG).


METHODS
Clinical data of 24 patients who received D-STLDG from April 2013 to April 2014, and 45 patients who received LADG from March 2010 to December 2012 were retrospectively analyzed. The operative time, intra-operative blood loss, post-operative recovery time of intestinal function, post-operative pain, the length of post-operative hospital stay and the incidence of post-operative complications (infection, obstruction and delayed gastric emptying) were compared between the two groups.


RESULTS
All procedures were completed successfully and all patients of both groups were discharged smoothly from hospital. Compared with LADG, D-STLDG had shorter operative time (175.3±64.7 min vs. 205.8±42.2 min, P<0.05), less intra-operative blood (50.8±25.3 ml vs. 75.2±22.5 ml, P<0.05), shorter post-operative recovery time of intestinal function (1.2±0.5 d vs. 2.1±0.8 d, P<0.05), less post-operative pain (5.6±0.7 vs. 7.8±0.5, P<0.05), shorter post-operative hospital stay (8.5±2.2 d vs. 10.5±3.5 d, P<0.05). There were no significant difference in surgical margins achieved, the number of lymph nodes retrieved or the incidence of post-operative complications (infection, obstruction and delayed gastric emptying) (P>0.05).


CONCLUSION
The delta-shaped anastomosis of reconstructing the digestive tract in TLDG appears to be safe, feasible and associated to faster recovery.