To investigate the efficacy of the modified inverted hand-sutured Overlap anastomosis in laparoscopic total gastrectomy (LTG).

A prospective selection was made of 178 gastric cancer patients who underwent LTG at the Affiliated Hospital of Tangshan Vocational and Technical College from January 2020 to March 2022. The patients were divided into the modified group (undergoing modified inverted hand-sutured Overlap anastomosis) and the traditional group (undergoing traditional Overlap anastomosis) using a random number table method, with 89 patients in each group. Statistical analysis was performed using SPSS 22.0 software. Measurement data conforming to normal distribution, were expressed as (±s). Independent sample t test was used for comparison between the two groups, and paired sample t test was used for intragroup comparison. Count data were expressed as [cases (%)] and analyzed using the χ² test. Kaplan-Meier survival curves were plotted to evaluate the 3-year postoperative survival of patients in both groups, and the Log-Rank test was used to compare survival differences between groups. P<0.05 was considered statistically significant.

All patients in both groups successfully completed LTG, with no conversion to open surgery or perioperative deaths. The operation time and anastomosis time in the modified group were significantly shorter than those in the traditional group, with statistically significant differences (P<0.05). After surgery, the levels of D-lactate (D-LAC), endotoxin (ET), and diamine oxidase (DAO) in both groups were significantly higher than those before surgery, and the levels in the modified group were lower than those in the traditional group. Meanwhile, the postoperative decreases in intestinal villus height and crypt depth in the modified group were smaller than those in the traditional group, with statistically significant differences (P<0.05). The total incidence of postoperative complications in the modified group was significantly lower than that in the traditional group (4.5% vs. 15.2%), with a statistically significant difference (P<0.05). The overall survival rate was 61.8% in the modified group and 51.7% in the traditional group. The comparison of overall survival rates between the two groups (Log-Rank χ²=6.052, P=0.014) showed a statistically significant difference (P<0.05).

The modified inverted hand-sutured Overlap anastomosis shows significant advantages in LTG. This anastomotic method not only reduces the difficulty of anastomotic operation, simplifies the surgical process, and significantly shortens the operation time but also causes less damage to the intestinal mucosal barrier function and effectively reduces the incidence of postoperative complications. Overall, the modified inverted hand-sutured Overlap anastomosis is an ideal anastomotic method in LTG with clinical application value.