To explore the clinical outcome of laparoscopic D2 total gastrectomy with self-pulling and transected esophagojejunostomy (SPLT) anastomosis for advanced gastric cancer.

Retrospective analysis were performed on the data of 96 patients with advanced gastric cancer who received laparoscopic D2 total gastrectomy from April 2016 to October 2019. According to different anastomosis methods, the patients were divided into two groups: the patients in the improved group received modified SPLT anastomosis, while Roux-en-Y anastomosis were performed in the traditional group. Statistical analysis were performed by using SPSS23.0 software., Measurement data such as intraoperative and postoperative conditions, pain scale score were expressed as and were analyzed by using t test. Complications were tested by using χ² test. A P value of <0.05 was considered as statistically significant difference.

The operative time, anastomosis time, intraoperative blood loss, postoperative first defecation time, first feeding time, first ambulation time and postoperative pain score on POD5 were significantly lower in the improved group than those in the traditional group respectively (P<0.05). The postoperative complications incidence of 10.4% in the improved group was lower than 27.1% in the traditional group (P<0.05).

Compared with traditional methods, laparoscopic D2 total gastrectomy for gastric cancer patients by using modified SPLT anastomosis is safe and reliable, it has the advantages of shorter operation time, less intraoperative blood loss, less postoperative pain and complications.