To compare the application effect of different staplers in Roux-en-Y anastomosis during laparoscopic radical gastrectomy for distal gastric cancer.

The clinical data of 135 patients with distal gastric adenocarcinoma who underwent laparoscopic radical gastrectomy Roux-en-Y anastomosis from October 2020 to October 2023 were retrospectively analyzed. The patients were divided into group A (n=66 cases, circular stapler) and group B (n=69 cases, linear cutting and closing device) according to the different staplers used during reconstruction of residual gastrojejunal anastomosis. SPSS 27.0 software was used to process the data. The measurement data such as operation, postoperative recovery and nutritional status were expressed as (), and independent sample t test was used. The statistical data of postoperative complications in the near and long term were χ² test or Fisher exact test. P<0.05 was considered statistically significant.

There was no significant difference in operation time, intraoperative blood loss, distance from lesion to upper incisal margin, distance from lesion to lower incisal margin, and total number of lymph nodes dissection between the two groups (P>0.05). The time of first postoperative exhaust and first intake of liquid diet in group B were shorter than those in group A (P<0.05). There was no statistical significance in the total incidence of postoperative complications between the two groups (P>0.05), but compared with group A, the incidence of anastomotic stenosis in group B was lower at 6 months after surgery (P<0.05). Six months after surgery, the levels of hemoglobin, total albumin and albumin in 2 groups were lower than before surgery, but those in group B were higher than those in group A (P<0.05).

In the Roux-en-Y anastomosis of laparoscopic radical gastrectomy for distal gastric cancer, both circular stapler and linear cutting and closing device are feasible. However, compared with circular stapler, linear cutting and closing device can shorten the postoperative exhaust time and liquid diet time of patients, reduce the postoperative long-term anastomotic stenosis rate, and improve the long-term postoperative nutritional status of patients.