Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2022; 14(4): 315-328
Published online Apr 27, 2022. doi: 10.4240/wjgs.v14.i4.315
How to examine anastomotic integrity intraoperatively in totally laparoscopic radical gastrectomy? Methylene blue testing prevents technical defect-related anastomotic leaks
Chun Deng, Yang Liu, Zhen-Yu Zhang, Heng-Duo Qi, Zhi Guo, Xu Zhao, Xiao-Jun Li
Chun Deng, Yang Liu, Zhen-Yu Zhang, Heng-Duo Qi, Zhi Guo, Xu Zhao, Xiao-Jun Li, Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, China
Author contributions: Deng C designed and performed the research and wrote the paper; Liu Y, Zhang ZY, and Qi HD designed the research and supervised the report; Guo Z and Zhao X provided clinical advice; Li XJ designed and performed the research and supervised the report.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Shaanxi Provincial People's Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Jun Li, MD, Professor, Surgeon, Department of General Surgery, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Xi'an 710068, Shaanxi Province, China. lixiaojun20040912@163.com
Received: November 11, 2021
Peer-review started: November 11, 2021
First decision: January 9, 2022
Revised: January 20, 2022
Accepted: April 4, 2022
Article in press: April 4, 2022
Published online: April 27, 2022
Processing time: 164 Days and 4.7 Hours
Core Tip

Core Tip: We reviewed the outcomes of 513 consecutive patients with gastric cancer who underwent totally laparoscopic radical gastrectomy with and without intraoperative methylene blue testing at Shaanxi Provincial People's Hospital from January 2017 to December 2019. We found that intraoperative methylene blue testing is an effective method to evaluate the integrity of anastomosis during totally laparoscopic radical gastrectomy and could reduce the incidence of postoperative anastomotic leaks. Preoperative complications, totally laparoscopic total gastrectomy, and neoadjuvant chemotherapy are independent risk factors for postoperative anastomotic leaks.