BACKGROUND: 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. PURPOSE: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
BACKGROUND: 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. PURPOSE: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Authors: Salvador Morales-Conde; Andrea Peeters; Yannick M Meyer; Stavros A Antoniou; Isaías Alarcón Del Agua; Alberto Arezzo; Simone Arolfo; Amir Ben Yehuda; Luigi Boni; Elisa Cassinotti; Giovanni Dapri; Tao Yang; Sofie Fransen; Antonello Forgione; Shahab Hajibandeh; Shahin Hajibandeh; Michele Mazzola; Marco Migliore; Christof Mittermair; Doris Mittermair; Antonio Morandeira-Rivas; Carlos Moreno-Sanz; Andrea Morlacchi; Eran Nizri; Myrthe Nuijts; Jonas Raakow; Francisco M Sánchez-Margallo; Juan A Sánchez-Margallo; Amir Szold; Helmut Weiss; Michael Weiss; Ricardo Zorron; Nicole D Bouvy Journal: Surg Endosc Date: 2019-02-15 Impact factor: 4.584
Authors: Boram Lee; Sang Il Youn; Kanghaeng Lee; Yongjoon Won; Sahong Min; Yoon Taek Lee; Young Suk Park; Sang-Hoon Ahn; Do Joong Park; Hyung-Ho Kim Journal: Ann Surg Treat Res Date: 2021-02-01 Impact factor: 1.859