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A randomized controlled trial of single-port versus multi-port laparoscopic distal gastrectomy for gastric cancer

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Abstract

Objective

This prospective randomized trial compared the invasiveness of laparoscopic gastrectomy using a single-port approach with that of a conventional multi-port approach in the treatment of gastric cancer.

Summary Background Data

The benefit of single-port laparoscopic gastrectomy (SLG) over multi-port laparoscopic gastrectomy (MLG) has yet to be confirmed in a well-designed study.

Methods

One hundred and one patients who were scheduled to undergo laparoscopic distal gastrectomy for histologically confirmed clinical stage I gastric cancer between April 2016 and September 2018 were randomly allocated to SLG (n = 50) or MLG (n = 51). The primary endpoints were the postoperative visual analog scale pain scores. Secondary endpoints were frequency of use of analgesia, short-term outcomes, such as operating time, intraoperative blood loss, inflammatory reactions, postoperative morbidity, and 90-day mortality.

Results

The postoperative pain score was significantly lower in the SLG group than in the MLG group (p < 0.001) on the operative day and the postoperative day 1–7. Analgesics were administered significantly less often in the SLG group than in the MLG group (1 vs. 3 days, p = 0.0078) and the duration of use of analgesics was significantly shorter in the SLG group (2 vs. 3 days, p = 0.0171). The operating time was significantly shorter in the SLG group than in the MLG group (169 vs. 182 min, p = 0.0399). Other surgical outcomes were comparable between the study groups.

Conclusions

SLG was shown to be safe and feasible in the treatment of gastric cancer with better short-term results in terms of less severe pain and may be suitable for treatment of cStage I gastric cancer.

Clinical trial registration:

UMIN000022218

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan

    Takeshi Omori, Kazuyoshi Yamamoto, Hisashi Hara, Naoki Shinno, Masaaki Yamamoto, Keijirou Sugimura, Hiroshi Wada, Hidenori Takahashi, Masayoshi Yasui, Hiroshi Miyata, Masayuki Ohue, Masahiko Yano & Masato Sakon

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  1. Takeshi Omori
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  2. Kazuyoshi Yamamoto
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  3. Hisashi Hara
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  4. Naoki Shinno
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  5. Masaaki Yamamoto
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  6. Keijirou Sugimura
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  11. Masayuki Ohue
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  12. Masahiko Yano
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  13. Masato Sakon
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Correspondence to Takeshi Omori.

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Disclosures

Drs. Takeshi Omori, Kazuyoshi Yamamoto, Hisashi Hara, Naoki, Shinno, Masaaki Yamamoto, Keijirou Sugimura, Hiroshi Wada, Hidenori Takahashi, Masayoshi Yasui, Hiroshi Miyata, Masayuki Ohue, Masahiko Yano, and Masato Sakon have no conflicts of interest or financial ties to declare.

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Omori, T., Yamamoto, K., Hara, H. et al. A randomized controlled trial of single-port versus multi-port laparoscopic distal gastrectomy for gastric cancer. Surg Endosc 35, 4485–4493 (2021). https://doi.org/10.1007/s00464-020-07955-0

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  • DOI: https://doi.org/10.1007/s00464-020-07955-0

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