Comparison of Single-Incision and Conventional Multi-Port Laparoscopic Distal Gastrectomy with D2 Lymph Node Dissection for Gastric Cancer: A Propensity Score-Matched Analysis
- 10 August 2016
- journal article
- research article
- Published by Springer Science and Business Media LLC in Annals of Surgical Oncology
- Vol. 23 (S5), 817-824
- https://doi.org/10.1245/s10434-016-5485-8
Abstract
Single-incision laparoscopic surgery maximizes the advantages of laparoscopic surgery by reducing abdominal trauma; however, few comparative studies have addressed its role in gastric cancer. This study sought to demonstrate the safety and feasibility of single-incision laparoscopic distal gastrectomy (SLDG) with radical D2 lymphadenectomy by comparing its short- and long-term outcomes with those of conventional multi-port laparoscopic surgery (MLDG). From October 2007 to December 2011, we identified 175 patients with clinical stage I-III gastric cancer who underwent SLDG with D2 lymphadenectomy (n = 90) and MLDG (n = 85) according to a review of our prospective gastric cancer database in our institute. One-to-one propensity score matching was performed to compare short-term outcomes and long-term survival between the two groups. Mean operative time was similar between the two groups, while blood loss was significantly lower in the SLDG group than in the MLDG group. Postoperative recovery was faster in the SLDG group in terms of earlier initiation of oral intake, less use of analgesics, and shorter hospital stay. Serum C-reactive protein levels were significantly lower in the SLDG group than in the MLDG group on postoperative days 1, 3, and 7, and the 5-year overall survival rate was not significantly different between the two groups (93.7 vs. 87.6 %; p = 0.689). This study shows that SLDG with D2 lymphadenectomy is safe and feasible for gastric cancer, with better short-term outcomes than MLDG and acceptable oncologic outcomes. Thus, SLDG may be an attractive surgical alternative in minimally invasive surgery.Keywords
This publication has 22 references indexed in Scilit:
- The interleukin-6 receptor as a target for prevention of coronary heart disease: a mendelian randomisation analysisThe Lancet, 2012
- Comparison of long-term results between laparoscopy-assisted gastrectomy and open gastrectomy with D2 lymph node dissection for advanced gastric cancerSurgical Endoscopy, 2011
- Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancerSurgical Endoscopy, 2011
- Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703)Gastric Cancer, 2010
- Subtotal gastrectomy with D2 dissection by minimally invasive surgery for distal adenocarcinoma of the stomach: results and 5-year survivalSurgical Endoscopy, 2010
- A Simple and Safe Method for Gastrojejunostomy in Laparoscopic Distal Gastrectomy Using the Hemidouble-Stapling Technique: Efficient Purse-String Stapling TechniqueDigestive Surgery, 2009
- Laparoscopic-assisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancerSurgical Endoscopy, 2008
- Comparison of laparoscopically assisted and open radical distal gastrectomy with extended lymphadenectomy for gastric cancer managementSurgical Endoscopy, 2006
- A simple technique for circular-stapled Billroth I reconstruction in laparoscopic gastrectomySurgical Endoscopy, 2005
- Classification of Surgical ComplicationsAnnals of Surgery, 2004