Pure Single-Port Laparoscopic Distal Gastrectomy for Early Gastric Cancer: Comparative Study with Multi-Port Laparoscopic Distal Gastrectomy
- 1 November 2014
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American College of Surgeons
- Vol. 219 (5), 933-943
- https://doi.org/10.1016/j.jamcollsurg.2014.07.009
Abstract
The purpose of this study was to show the feasibility and safety of pure single-port laparoscopic distal gastrectomy (SDG) by comparing its short-term outcomes with those of conventional multiport totally laparoscopic distal gastrectomy (TLDG). Prospectively collected data of 50 gastric cancer patients who underwent pure SDG from November 2011 through October 2013 were compared with the matched data of 50 TLDG patients. Mean operation time (144.5 vs 140.3 minutes; p = 0.561) and number of harvested lymph nodes (51.7 ± 16.3 vs 52.4 ± 17.9; p = 0.836) were comparable. Estimated blood loss was lower in the SDG patients (50.5 ± 31.5 mL vs 87.5 ± 79.6 mL; p = 0.007). Postoperative recovery was faster in the SDG patients in terms of lower maximum pain score on the operative day (6.1 ± 1.4 vs 6.9 ± 1.5; p = 0.015) and postoperative day 1 (4.6 ± 1.0 vs 5.5 ± 1.4; p < 0.001), less use of parenteral analgesics (0.8 ± 1.0 vs 1.4 ± 1.0; p = 0.020), and less increase in C-reactive protein level on postoperative day 5 (4.57 ± 6.26 mg/L vs 8.51 ± 5.25 mg/L; p = 0.008). Postoperative morbidity occurred in 6 (12%) and 5 (10%) patients in the SDG and TLDG group, respectively. This study showed that pure SDG is both safe and feasible for early gastric cancer, with similar operation time and better short-term outcomes than TLDG in terms of postoperative pain, estimated blood loss, inflammatory reaction, and cosmetic result.Keywords
This publication has 24 references indexed in Scilit:
- Comparison of Short-Term Surgical Outcomes after Single-Incision Laparoscopic versus Multiport Laparoscopic Right Colectomy: A Two-Center, Prospective Case-Controlled Study of 100 PatientsDigestive Surgery, 2012
- The Short-term Outcomes of Conventional and Single-port Laparoscopic Surgery for Colorectal CancerAnnals of Surgery, 2011
- Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancerSurgical Endoscopy, 2011
- Laparoscopic Surgery Performed Through a Single Incision: A Systematic Review of the Current LiteratureJournal of the American College of Surgeons, 2011
- The current status and future perspectives of laparoscopic surgery for gastric cancerJournal of the Korean Surgical Society, 2011
- Combined suture retraction of the falciform ligament and the left lobe of the liver during laparoscopic total gastrectomySurgical Endoscopy, 2010
- Morbidity and Mortality of Laparoscopic Gastrectomy Versus Open Gastrectomy for Gastric CancerAnnals of Surgery, 2010
- Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentationSurgical Endoscopy, 2009
- Transvaginal Natural Orifice Translumenal Endoscopic Surgery CholecystectomyAnnals of Surgery, 2009
- Learning Curve for Laparoscopy-assisted Distal Gastrectomy With Regional Lymph Node Dissection for Early Gastric CancerSurgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2008