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Updated: Dec 27, 2025
Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
Laparoscopic D2 plus complete mesogastrium excision using the "enjoyable space" approach versus conventional D2 total
Chang-Yue Zheng1,2, Zhi-Yong Dong3, Long-Zhi Zheng1,2
1Department of Gastrointestinal Surgery, the Affiliated Hospital of Putian University, Putian, Fujian Province, China.
Introduction:
Laparoscopy-assisted radical total gastrectomy is technically demanding.
Aim:
To introduce the "enjoyable space" approach to achieve D2 plus complete mesogastrium excision (CME) and to investigate its safety and feasibility.
Material And Methods:
Between January 2015 and December 2017, 165 patients with primary advanced upper gastric cancer underwent laparoscopy-assisted radical total gastrectomy. Among these patients, 81 underwent conventional D2 total gastrectomy (D2 group) and 84 underwent D2 plus CME total gastrectomy (D2 + CME group). Clinicopathological characteristics, surgical outcomes and postoperative complications were compared between the two groups.
Results:
There were no significant differences between the two groups (p > 0.05) in clinicopathological characteristics. However, the D2 + CME group had a longer mean operative time, lower mean blood loss and slightly higher mean number of retrieved lymph nodes (LNs) than the D2 group (p < 0.05 each). The mean time to first flatus, liquid diet, and soft diet and the duration of hospital stay were similar between the two groups (p > 0.05 each). No significant difference in postoperative complication rates was found between the groups (16.0% vs. 9.5%, p > 0.05).
Conclusions:
The "enjoyable space" approach is an option to achieve D2 + CME, and its safety and feasibility over conventional method are confirmed with lower intraoperative blood loss and more harvested LNs.
