Comparison of outer and inner omental bursa approach for hand assisted laparoscopic total gastrectomy in gastric cancer patients / 中华普通外科杂志

ABSTRACT

Objective To evaluate the feasibility and safety of hand assisted laparoscopic total gastrectomy for gastric cancer by two different operative approaches.Methods 191 patients of proximal or gastric corpus cancer operated at our department from Jan 2015 to Dec 2017 were divided into two groups:by outer omental bursa approach group (OBA) and through inner omental bursa approach group (IBA).Operative time,estimated blood loss,number of lymph node retrieval,times of analgesic injection,time to the first flatus and postoperative hospital stay were compared between the two groups.Results Estimated blood loss,times of analgesic injection,time to the first flatus and postoperative hospital stay were not statistically different between the two groups.The operative time was significantly shorter in the IBA than the OBA.There were no significant differences in tumor size,retrieved lymph nodes,AJCC/UICC staging and resection margins between the two groups.Conclusion Hand assisted laparoscopic total gastrectomy by the outer omental bursa approach is technically feasible and safe,and allows for adequate lymphadenectomy.