Abstract
OBJECTIVE: Whether Totally Laparoscopic Gastrectomy (TLG) is beneficial for patients with gastric cancer remains not fully understood. This study was to evaluate the advantages of Totally Laparoscopic Gastrectomy (TLG) for treating Gastric Cancer (GC). METHODS: From January 2019 to December 2021, 380 patients with gastric cancer were included into this study (190 per group). The outcomes of interest, including postoperative recovery, inflammation, and oncological results, were compared between the two groups. RESULTS: The patient baselines between the two groups were comparable. The TLG group had lower risks of wound infection (p = 0.02) and total complications (p = 0.03) compared to LAG. The TLG group exhibited significantly shorter operative time (median: 215 vs. 240 min, p < 0.001), less intraoperative blood loss (median: 50 vs. 100 mL, p < 0.001), shorter time to first flatus (median: 3 vs. 4 days, p < 0.001), and reduced length of postoperative hospital stay (p < 0.001). Furthermore, patients in the TLG group exhibited lower White Blood Cell (WBC) counts on POD 1 compared to patients in the LAG group (mean 11.74 vs. 12.75 × 10^9/L; p = 0.003). Multivariate logistic regression analysis revealed that TLG was an independent predictor of shorter postoperative hospitalization (OR (95% CI): 0.54 (0.30‒0.95), p = 0.03). Interestingly, the TLG group had more lymph nodes harvested than the LAG group (median (range): 23 (2‒88) vs. 23 (2‒88), p < 0.001). CONCLUSIONS: This study demonstrates that TLG has a lower risk of complications and faster postoperative recovery, thus TLG is superior to LAG for the treatment of gastric cancer.