Abstract: Objective:To compare the influence of totally laparoscopic total gastrectomy(TLTG) and laparoscopicassisted total gastrectomy(LATG) on postoperative rehabilitation and expression of programmed cell deathLigand 1(PDL1) on peripheral blood cells for patients with gastric cancer.Methods:108 patients underwent laparoscopic radical gastrectomy were randomly divided into the TLTG group and LATG group,54 cases/group.The intraoperative conditions,postoperative rehabilitation and complications were compared in 2 groups.Peripheral blood T lymphocyte subsets and cell surface programmed cell death1(PD1)/PDL1 were measured before and after surgery.Results:Both groups had completed the operation.There were no statistically significant differences in the number of lymph node dissections,intraoperative blood loss,esophageal jejunal anastomosis,total surgery time,ground activities,CD8+,and cell surface PD1 in 2 groups(P＞0.05).Compared with the LATG group,the incision length,analgesia,first exhaust,inflow(soft) food,postoperative hospital stay,total,high and moderately poorly differentiated cell surface PDL1 expression and complications had induced,T lymphocyte subsets had increased(P＜0.05).Conclusion:Compared with LATG,TLTG has the advantages of minimal invasiveness,less postoperative pain and faster recovery in the treatment of gastric cancer,lower T lymphocyte subsets and PDL1,and less stress response or immunosuppression.

Key words: radical surgery of gastric cancer, laparoscopic, programmed cell deathLigand 1