Introduction

Pylorus-preserving gastrectomy (PPG) has been accepted as a representative function-preserving procedure for early gastric cancer (EGC) in the middle stomach. Totally, intracorporeal laparoscopic gastrectomy can provide better aesthetics, be less invasive, and allow faster postoperative recovery. Here, we first describe the surgical procedure of totally laparoscopic pylorus-preserving gastrectomy with intracorporeal hand-sewn anastomosis (TLPPG-IHSA).

Methods

After standard procedure of lymph node dissection and middle stomach resection, we used two double-needle barbed sutures to perform a layer-to-layer manual anastomosis of the anterior and posterior walls in the abdominal cavity. Twelve patients with preoperatively diagnosed clinical EGC located in the middle third of the stomach underwent TLPPG-IHSA between August 2019 and January 2021.

Results

A total of 12 patients with EGC successfully underwent TLPPG-IHSA. Only one patient (8.3%) suffered postoperative gastric stasis. No complications or recurrence occurred in other patients during half a year after surgery.

Conclusion

TLPPG-IHSA is considered technically feasible to treat EGC located in the middle third of the stomach.

中文翻译：

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全腹腔镜保留幽门胃切除术后中、晚期早期胃癌体内手缝吻合的临床经验

 介绍

保留幽门的胃切除术（PPG）已被认为是中胃早期胃癌（EGC）的代表性功能保留手术。总而言之，体内腹腔镜胃切除术可以提供更好的美观性、侵入性更小并且术后恢复更快。在这里，我们首先描述完全腹腔镜保留幽门胃切除术与体内手缝吻合术（TLPPG-IHSA）的手术过程。

 方法

经过淋巴结清扫和中胃切除的标准程序后，我们使用两根双针倒刺缝合线对腹腔前壁和后壁进行了层层手工吻合。 2019 年 8 月至 2021 年 1 月期间，12 名术前诊断为临床 EGC 且位于胃中三分之一的患者接受了 TLPPG-IHSA。

 结果

共有 12 名 EGC 患者成功接受了 TLPPG-IHSA。仅1例患者（8.3%）出现术后胃瘀滞。其他患者术后半年内未出现并发症或复发。

 结论

TLPPG-IHSA 被认为治疗位于胃中部三分之一的 EGC 在技术上是可行的。