Application of invisible incision in laparoscopic radical gastrectomy

Abstract

Objective To investigate the feasibility and safety of invisible incision in laparoscopic radical gastrectomy. Methods The clinical data of 69 patients who underwent laparoscopic radical gastrectomy with invisible incision in the First Affiliated Hospital of Zhengzhou University from July 2018 to October 2018 were analyzed retrospectively. All patients underwent total laparoscopic radical gastrectomy in accordance with D2 + CME principle, and the specimens were resected and placed in the specimen bag. Radical total gastrectomy + Roux-en-Y esophagojejunostomy was performed for proximal gastric cancer, gastric body cancer, small curved gastric cancer and signet ring cell cancer. While radical distal gastrectomy + Billorth Ⅱ gastrojejunostomy was performed for gastric sinus cancer. Then, we maked a 4 cm transverse incision 2 cm above the superior margin of pubic symphysis to extract the specimen together with the specimen bag. The intraoperative and postoperative status and follow-up status of the patients were observed. Results All of the 69 patients underwent surgery successfully, and no one needed laparotomy or other surgical methods. Seven of the 69 patients underwent laparoscopic distal gastrectomy, and 62 patients underwent laparoscopic total gastrectomy. The operation time, volume of intraoperative blood loss, harvested lymph nodes, the first time to get out of bed postoperatively, the first flatus postoperatively, and duration of postoperative hospital stay were (192.0±53.0) min, (68.8±36.9) ml, (29.9±5.7) pieces, (1.9±0.4) d, (3.2±0.9) d, (7.7±3.4) d, respectively. And the residual rate of postoperative margin was 0. Postoperative complications occurred in 4 cases, including 3 cases incision infection and 1 case anastomotic fistula. All patients were discharged after conservative treatment. Follow-up was performed to all the patients by hospitalization or telephone, and all patients were satisfied with the cosmetic effects. Conclusions The application of invisible incision in laparoscopic radical gastrectomy is safe and reliable. Moreover, it has good cosmetic effects. Key words: Gastric cancer; Laparoscopic gastrectomy; Invisible incision