To explore the differences of short-term outcomes and patients’ quality of life (QoL) between totally laparoscopic distal gastrectomy (TLDG) and laparoscopic-assisted distal gastrectomy (LADG).

The clinical data of 98 patients from Jan. 2017 to Jan. 2020 who underwent laparoscopic distal gastrectomy with Billroth-Ⅱ+ Braun reconstruction were retrospectively analyzed.They were divided into TLDG group (n=41) and LADG group (n=57). The clinical data and results of QoL questionnaires 6 months and 12 months after operation were compared between the two groups.

The clinical characteristics and pathological data showed no significant difference between the two groups (P>0.05). Compared with the LADG group, the TLDG group had earlier time of first flatus, quicker return to a liquid diet and shorter postoperative hospital stay (P=0.033, P<0.010, P<0.010). Besides, in the LADG group, the blood loss was greater, the level of Hemoglobin was higher and the length of longest incision was longer as compared with the TLDG group(P=0.035, P=0.012, P<0.001). There were no significant differences in the morbidity of postoperative complications between two groups (P>0.05). As for the QoL, the global health status of TLDG group showed better score than that of LADG group at 12 months after surgery(P=0.039). Other function scales and symptom scales did not show any significant differences between the two groups(P>0.05).

Compared with LADG, TLDG permitted faster postoperative recovery, less intraoperative blood loss, shorter length of incision and higher level of hemoglobin after operation. It also permitted better global health status of patients at 12 months after surgery, but showed no superiority in the morbidity of postoperative complications as compared with LADG.