The Advantages and Disadvantages of Linear Anastomat and Tubular Anastomat in Radical Gastrectomy of Distal Gastric Cancer

Inclusion criteria

• Age ≤ 18 years old ≤75 years old;
• The primary gastric lesions were diagnosed as gastric adenocarcinoma (papillary adenocarcinoma pap, tubular adenocarcinoma tub, mucinous adenocarcinoma muc, sig-ring cell carcinoma, and poorly differentiated adenocarcinoma por) by gastroscopic biopsy.
• The patient was clinically diagnosed with gastric cancer (in line with clinical signs of gastrointestinal reconstruction after distal subtotal gastrectomy for gastric cancer);
• Implantation metastasis without peritoneum (confirmed by laparoscopic exploratory surgery);
• It is estimated that R0 results can be obtained after D2 radical resection of distal gastric cancer (also applicable for multiple primary lower cancers);
• Karnofsky score ≥60 points;
• Preoperative ASA score: I, II, or III; 8。 Routine blood examination (no transfusion within the past 14 days) : HB≥90g/L;ANC ≥1.5×109/L;PLT ≥80×109/L；

• Blood biochemical examination: BIL <1.5 times the upper limit of normal value (ULN);ALT and AST<2.5× ULN;Crea≤1 x ULN.

Exclusion criteria

• Previous history of upper abdominal surgery (including gastric ESD/EMR, except laparoscopic cholecystectomy);
• History of acute pancreatitis;
• Preoperative imaging examination indicated fusion of enlarged lymph nodes (maximum diameter >3cm);
• Gastric cancer patients who have received neoadjuvant therapy;
• History of other malignant diseases within the past 5 years;
• History of unstable angina pectoris, myocardial infarction, cerebral infarction, or cerebral hemorrhage within the past 6 months;
• History of continuous systemic corticosteroid therapy in the past 1 month;
• Concurrent surgical treatment for other diseases is required;
• Patients with gastric cancer complications (bleeding, perforation) requiring emergency surgery;
• Pyloric obstruction;
• Lung function test FEV1< 50% of the expected value;
• Pregnant or lactating women;
• Suffers from severe mental illness;
• Participate in other clinical studies at the same time;
• Refused to sign the first round of study informed consent;
• Unable or unwilling to comply with research requirements;
• Patients with PD after neoadjuvant chemotherapy and unable to undergo distal gastrectomy;
• Patients undergoing emergency surgery due to tumor bleeding, perforation and obstruction during chemotherapy.