Abstract
OBJECTIVE: To investigate the therapeutic efficacy of totally laparoscopic total gastrectomy (TLTG) versus laparoscopy-assisted total gastrectomy (LATG) in gastric cancer (GC) treatment, as well as their effects on postoperative inflammation and glucose and lipid metabolic status. METHODS: Clinical data of 68 individuals with GC who underwent LATG (n=31) and TLTG (n=37) from January 2020 to December 2022 were procured. This included intraoperative blood loss, operative time, incision length, number of lymph nodes dissected, postoperative complication rates, and recovery indicators, such as inflammation, glucose metabolism, and lipid metabolism. RESULTS: The TLTG cohort demonstrated significant advantages in intraoperative blood loss, operative time, and incision length compared to the LATG cohort. Furthermore, TLTG was superior in reducing the incidence of complications. Nevertheless, no substantial variation was observed in the quantity of lymph nodes dissected. Additionally, TLTG showed benefits in postoperative recovery, including better control of the inflammatory response, reduction of complication risks, shorter hospital stay, and alleviation of postoperative pain. TLTG also exhibited a reduced impact on inflammation and demonstrated greater effectiveness in improving postoperative glucose and lipid levels. CONCLUSION: TLTG surgery is associated with superior clinical outcomes in the treatment of GC compared to LATG, particularly in reducing surgical trauma and accelerating postoperative recovery. Furthermore, TLTG facilitates the resolution of postoperative inflammatory responses and the amelioration of metabolic disorders. The findings from this investigation advocate for the broader adoption of TLTG in the surgical treatment of GC.