Evaluation of efficacy of a polyglycolic acid sheet in laparoscopic gastrectomy for gastric cancer: a single-center retrospective study

Gastric cancer (GC) is one of the most common causes of cancer-related deaths worldwide. Gastrectomy with lymph node dissection is the standard treatment for GC worldwide. Due to advancements in surgical techniques, the use of laparoscopic gastrectomy (LG) has broadened. However, the incidence of post-operative pancreatic fistula (POPF) after LG is higher than that after open surgery, and the definition and measurement of POPF in gastrectomy have not yet been established. We introduced polyglycolic acid (PGA) sheet to prevent POPF after LG and retrospectively evaluated its effectiveness. Between April 2022 and June 2024, surgical interventions were performed for 170 patients with GC. Of these patients, 130 underwent LG. Among them, a PGA sheet was used in 62 patients (PGA group), while the remaining 68 patients did not receive PGA sheet (Control group). After propensity score matching, 44 patients were selected for the PGA group and 46 patients for the Control group. Statistically significant differences in ascitic amylase levels on post-operative day (POD) 1,3 and 5 between the groups were not observed. However, the PGA group showed a significantly greater reduction in the ascitic amylase levels from POD 1 to POD 5 compared with the Control group (p < 0.01). Additionally, no difference was observed in the incidence of Grade IIIa POPF and no POPF greater than Grade IIIb according to the Clavien-Dindo classification. The use of PGA sheets in LG for GC more pronounced decrease in ascitic amylase levels over time.