Laparoscopic distal gastrectomy with intracorporeall hand - sewn anastomosis for gastric cancer

Abstract Introduction: Laparoscopic distal gastrectomy with D2 lymph nodes dissection has become an ideal option for early gastric cancer, especially totally laparoscopic distal gastrectomy using intracorporeally hand–sewn anastomosis has many advantages. This study was performed to evaluate the safety and feasibility of this method in laparoscopic distal gastrectomy with lymph node dissection. Patients and methods: Prospective study with 6 gastric cancer patients was performed totally laparoscopic distal gastrectomy with D2 lymph nodes dissection using intracorporeally hand-sewn anastomosis at Gastrointestinal Surgery Department – Viet Duc University Hospital from 5/2021 to 5/2022. Results: 6 patients were performed totally laparoscopic distal gastrectomy with D2 lymph nodes dissection. One patient with cancer was in situ (Tis), one patient with tumor invaded the mucosa layer (T1a), two patients with tumor invaded the submucosal layer (T1b), one patient with tumor invaded the muscle layer (T2), one patient with with tumor invaded the serosa (T3). The mean number of harvested lymph nodes was 18,3 ± 7 (11-25). There was no open conversion. The mean operating time was 220.7 ± 45.3 min (180-266). The average length of post-operative stay was 7,3 ± 0,7 days (7-8 days). one case had a postoperative low-grade fever and one case had fever associated with slight inflammation around the drainage site. Conclusions: Totally laparoscopic distal gastrectomy with D2 lymph nodes dissection with intracorporeally hand–sewn Billroth II anastomosis appears to be a safe and efficient procedure. Patients recovered faster with less pain as well as aesthetically and economically high efficiency. Keywords: Totally laparoscopic distal gastrectomy, hand-sewn gastrointestinal anastomosis, early gastric cancer.