How to examine anastomotic integrity intraoperatively in totally laparoscopic radical gastrectomy? Methylene blue testing prevents technical defect-related anastomotic leaks

Table 4 Surgical variables according to the results of intraoperative methylene blue testing and postoperative anastomotic leaks

Variable	IMBT group	IMBT		P value	Control group	PAL		P value
		Negative	Positive (%)			Negative	Positive (%)
Cases	211	204	7 (3.3)	-	302	289	13 (4.3)	-
Operation time (h)
< 4	143	142	1 (0.7)	0.008	184	177	7 (4.0)	0.577
≥ 4	68	62	6 (8.8)		118	112	6 (5.1)
Amount of bleeding (mL)
< 400	132	130	2 (1.5)	0.136	202	194	8 (4.0)	0.765
≥ 400	79	74	5 (6.3)		100	95	5 (5.0)
Mode of operation
TLTG	100	95	5 (5.0)	0.200	146	136	10 (6.8)	0.046
TLDG	111	109	2 (1.8)		156	153	3 (1.9)
Surgeon’s experience (cases)
< 50	21	18	3(14.3)	0.021	24	21	3 (12.5)	0.074
≥ 50	190	186	4 (2.1)		278	268	10 (3.6)

IMBT: Intraoperative methylene blue testing; PAL: Postoperative anastomotic leak; TLTG: Totally laparoscopic total gastrectomy; TLDG: Totally laparoscopic distal gastrectomy.