Background We retrospectively reviewed and consecutively collected the clinical data of distal gastric cancer patients who received surgical treatment, and we discuss the safety and feasibility of double layered end-to-end anastomosis with continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy. Methods We reviewed the clinical data of 41 patients with distal gastric cancer from the gastroenterology department of the Second Affiliated Hospital of Dalian Medical University, from September 2018 to August 2019, who underwent totally laparoscopic distal gastrectomy. During the operation, the method of double layered end-to-end anastomosis with continuous manual suture was used for Billroth type I anastomosis to complete digestive tract reconstruction. All patients have been given a follow-up visit and gastroscopy three months after the operation. The peri-operative clinical information and postoperative follow-up information were collected for analysis, and the clinical application value was evaluated. Results General information: male(n = 27), female(n = 14), age = 65.02(SD 9.94) years, and BMI = 23.52(SD 2.56) kg/m2, Tumor location: antrum(32,78.0%), angle (6,14.6%), and body (3,7.3%). Clinical stage: I (27, 65.9%), II (7, 17.1%), and III (7, 17.1%). Operative information: operation time = 154.51(SD 33.37) min, anastomosis time = 26.88(SD 5.11) min; intraoperative bleeding = 66.34(SD 48.81) ml; first postoperative ambulation Median = 1(IQR 0) d, first postoperative flatus Median = 3(IQR 2) d, first postoperative diet Median = 3(IQR 1) d, postoperative hospital stay Median = 7(IQR 2) d, and total hospitalization cost = 10,935.00(SD 2205.72)USD. Differentiation degree: high and high-moderate (3,7.32%), moderate and poor-moderate (24, 58.54%), poor differentiation (14, 34.15%), dissected lymph nodes Median = 31(IQR 17), and positive lymph nodes Median = 0(IQR 1). Pathological stage: IA (20, 48.78%), IB (3, 7.32%), IIA (4, 9.76%), IIB (5, 12.20%), IIIA (1, 2.44%), IIIB (3, 7.32%), and IIIC (5, 12.20%). Complications (n = 4): lung infection (1, 2.44%), anastomotic leakage (1, 2.44%), and gastroparesis (2, 4.88%). Conclusion It is safe and feasible in clinical treatment to apply the method of double layered end-to-end anastomosis with continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy.

Background Retrospectively register the clinical data of distal gastric cancer patients who received surgical treatment, discuss the safety and feasibility of double needle-double layer continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy. Methods Review the clinical data of 41 patients with distal gastric cancer from the gastroenterology department of the Second Affiliated Hospital of Dalian Medical University, from September 2018 to August 2019, were accepted the totally laparoscopic distal gastrectomy. During the operation, the method of double needle-double layer continuous manual suture was used for Billroth I type anastomosis to complete digestive tract reconstruction. The peri-operative clinical information and postoperative follow-up information were collected for analysis, and the clinical application value was evaluated. Results General Information: Male (n = 27),Female(n = 14)༌Age(65.02 ± 9.94)years, BMI(23.52 ± 2.56)kg/m2; Tumor location: Antrum(32,78.0%), Angle (6,14.6%), Body (3,7.3%); Clinical stage: I (27,65.9%), II (7,17.1%), III (7,17.1%); Operative information: Operation time (154.51 ± 33.37)min, Anastomosis time (26.88 ± 5.11) min; Intraoperative bleeding (66.34 ± 48.81) ml; First postoperative ambulation (1.07 ± 0.26) d, First postoperative flatus(3.07 ± 1.08)d, First postoperative diet(3.41 ± 1.07)d༌Postoperative hospital stay(8.76 ± 6.64)d, Total hospitalization cost (70804.00 ± 14282.05)RMB yuan; Differentiation degree: High and high-moderate(3,7.32%), Moderate and poor-moderate (24,58.54%)༌Poor differentiation (14,34.15%); Dissected lymph node (32.76 ± 13.16), Positive lymph node (2.39 ± 4.06); Pathological stage: IA (20,48.78%), IB (3,7.32%), IIA (4,9.76%), IIB (5,12.20%), IIIA (1,2.44%), IIIB (3,7.32%), IIIC (5,12.20%); Complications(n = 4): Lung infection(1,2.44%)༌Anastomotic leakage (1,2.44%༉༌Gastroparesis (2,4.88%༉; Conclusion It is safe and feasible in clinical treatment to apply the method of double needle-double layer continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy.