Abstract: Objective To investigate the effect of total laparoscopy and laparoscopic-assisted radical gastrectomy in the elderly patients with distal gastric cancer. Methods A total of 80 elderly patients with distal gastric cancer admitted to the Second People's Hospital of Guilin from January to August 2021 were divided into the laparoscopic-assisted group (n=40) and the total laparoscopic group (n=40) according to the treatment method. And the clinical data was collected retrospectively. Both groups were followed up for 2 weeks. The indicators before and after operation, the scores of visual analogue scale(VAS) 1, 2 and 3 d after operation and the complications during follow-up were compared between the two groups. Results The intraoperative blood loss in the total laparoscopic group was lower than that in the laparoscopic-assisted group, and the time of gastrointestinal anastomosis, exhaust, feeding and hospital stay were shorter than those in the laparoscopic-assisted group (P<0.05). The scores of VAS decreased in the two groups 1, 2, 3 d after operation, especially in the total laparoscopic group (P<0.05). During follow-up, the incidence rate of incision infection, duodenal stump fistula, lymphatic leakage and anastomotic fistula in the total laparoscopic group was 2.50%, 0, 2.50% and 0, respectively, compared with 5.00%, 0, 5.00% and 2.50% in the laparoscopic-assisted group (P>0.05). Conclusions Compared with laparoscopic-assisted radical gastrectomy for distal gastric cancer, total laparoscopy can significantly reduce the intraoperative blood loss in the elderly patients with distal gastric cancer, relieve pain and promote recovery, with high safety.

Key words: gastric cancer, aged, laparoscopic-assisted, total laparoscopy, distal gastric cancer radical resection