Surgery, Gastroenterology and Oncology

Objective: To evaluate the outcomes, safety and effectiveness of laparoscopic total gastrectomy with D2 lymph node dissection with left-site surgeon and resection - closure of the duodenal stump in final phase after making esophageal anastomosis in gastric cancer treatment.

Method: Prospective, descriptive study on patients undergoing laparoscopic total gastrectomy and D2 lymphadenectomy with left-site surgeon and resection - closure of the duodenal stump in final phase after making esophageal anastomosis in gastric cancer treatment from 06 2016 â?" 03 2020.

Results: There were 70 patients in the study. The mean age was 59.9 years old, with a male female ratio of 4 1. ASA 1 and 2 accounted for 97.2% of patients. The average lesion size was 3.4 cm. In total, 78.6% of patients had adenocarcinoma; 15.7% cases had tumour sites found in the upper third of the stomach, and 75.7% were found in middle third of stomach; 4.3% of cancers were at stage IA, 11.4% at IB, 32.9% at IIA, 30% at stage IIB, 7.1% at IIIA, 11.4% IIIB and 2.9% IIIC; 100% patients received laparoscopic total gastrectomy and D2 lymph node dissection with left-site surgeon and posterior duodenectomy; 4.2% had minor complications during surgery, and 2.8% developed complications after surgery; no deaths occurred during and after surgery. The average number of retrieved lymph nodes was 21.5 nodes, the average number of metastatic lymph nodes was 2.6, and the lymph node station numbers 1, 2, 3, 4 and 7 had high rates of metastases. The mean surgical time was 206.8 minutes, and the mean hospital stay was 8.8 days. The mean overall survival was estimated as 43.8 months.

Conclusion: Laparoscopic total gastrectomy with D2 lymphadenectomy with left-site surgeon and final resection and closure of the duodenal stump demonstrated its safety and effectiveness in gastric adenocarcinoma treatment with less pain for patients, earlier movement recovery and lower hospitalization time.

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