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Comparison of Single-Incision and Conventional Multi-Port Laparoscopic Distal Gastrectomy with D2 Lymph Node Dissection for Gastric Cancer: A Propensity Score-Matched Analysis

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

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.

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Disclosure

Takeshi Omori, Yoshiyuki Fujiwara, JeongHo Moon, Keijiro Sugimura, Hiroshi Miyata, Toru Masuzawa, Kentaro Kishi, Norikatsu Miyoshi, Akira Tomokuni, Hirofumi Akita, Hidenori Takahashi, Syougo Kobayashi, Masayoshi Yasui, Masayuki Ohue, Masahiko Yano, and Masato Sakon have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

    Takeshi Omori MD, PhD, Yoshiyuki Fujiwara MD, PhD, JeongHo Moon MD, PhD, Keijiro Sugimura MD, PhD, Hiroshi Miyata MD, PhD, Norikatsu Miyoshi MD, PhD, Akira Tomokuni MD, PhD, Hirofumi Akita MD, PhD, Hidenori Takahashi MD, PhD, Syougo Kobayashi MD, PhD, Masayoshi Yasui MD, PhD, Masayuki Ohue MD, PhD, Masahiko Yano MD, PhD & Masato Sakon MD, PhD

  2. Department of Surgery, Osaka Police Hospital, Osaka, Japan

    Toru Masuzawa MD, PhD & Kentaro Kishi MD, PhD

Authors
  1. Takeshi Omori MD, PhD
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  2. Yoshiyuki Fujiwara MD, PhD
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  3. JeongHo Moon MD, PhD
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  4. Keijiro Sugimura MD, PhD
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  5. Hiroshi Miyata MD, PhD
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  6. Toru Masuzawa MD, PhD
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  7. Kentaro Kishi MD, PhD
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  8. Norikatsu Miyoshi MD, PhD
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  9. Akira Tomokuni MD, PhD
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  10. Hirofumi Akita MD, PhD
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  11. Hidenori Takahashi MD, PhD
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  12. Syougo Kobayashi MD, PhD
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  13. Masayoshi Yasui MD, PhD
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  14. Masayuki Ohue MD, PhD
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  15. Masahiko Yano MD, PhD
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  16. Masato Sakon MD, PhD
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Corresponding author

Correspondence to Takeshi Omori MD, PhD.

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Omori, T., Fujiwara, Y., Moon, J. et al. Comparison of Single-Incision and Conventional Multi-Port Laparoscopic Distal Gastrectomy with D2 Lymph Node Dissection for Gastric Cancer: A Propensity Score-Matched Analysis. Ann Surg Oncol 23 (Suppl 5), 817–824 (2016). https://doi.org/10.1245/s10434-016-5485-8

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  • DOI: https://doi.org/10.1245/s10434-016-5485-8

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