Objective To investigate the clinical value of midpoint‑priority suture (MPS) in digestive tract anastomosis in laparoscopic distal gastrectomy of gastric cancer.
Methods The retrospective cohort study was conducted. The clinicopathological data of 72 patients with gastric cancer who were admitted to the First Affiliated Hospital of Xiamen University from January 2019 to June 2022 were collected. There were 52 males and 20 females, aged (56±11)years. All 72 patients underwent totally laparoscopic distal gastrectomy (TLDG), in which 50 patients being admitted from January to December 2019 and treated with the side‑priority suture (SPS) method for digestive tract reconstruction were divided into the SPS group, and 22 patients being admitted from June 2021 to June 2022 and treated with MPS method for digestive tract reconstruction were divided into the MPS group, respectively. Observation indicators: (1) surgical conditions; (2) complications; (3) follow‑up. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann⁃Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi‑square test or Fisher exact probability. Comparison of ordinal data was conducted using the sum test.
Results (1) Surgical conditions. All 72 patients underwent TLDG successfully, without conversion to open surgery. There was a significant difference in the time to postoperative first intake of liquid diet between the two groups (t=-2.592, P<0.05). (2) Complications. Cases with postoperative short‑term complications in the MPS group and the SPS group were 5 and 20, respectively, showing no significant difference between the two groups (P>0.05). There was no significant difference in the Clavien‑Dindo score of postoperative complications and anastomotic complications between the two groups (P>0.05). All patients with complications were recovered and discharged after treatment. (3) Follow‑up. Nineteen patients in the MPS group were followed up for 20(range, 1-24)months, including 11 case of gastroscope follow-up. Forty‑nine patients in the SPS group were followed up for 18(range, 2-25)months, including 28 cases of gastroscope follow-up. There was no significant difference in recurrence and metastasis, long‑term complications, postoperative bile reflux, residual gastritis, and food retention between the two groups (P>0.05).
Conclusion The MPS can be used into digestive tract anastomosis in laparoscopic distal gastrectomy of gastric cancer.
DownLoad: