Pure Single-Port Laparoscopic Distal Gastrectomy for Early Gastric Cancer: Comparative Study with Multi-Port Laparoscopic Distal Gastrectomy

초록

BACKGROUND: 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). STUDY DESIGN: 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. RESULTS: 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. CONCLUSIONS: 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. (C) 2014 by the American College of Surgeons

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