腹腔镜胃切除术中5端口方法的必要性 - 腹腔镜全胃镜胃切除术治疗胃癌的可行性 - 前瞻性队列研究

Is the 5-ports approach necessary in laparoscopic gastrectomy- Feasibility of reduced-port totally laparoscopic gastrectomy for the treatment of gastric cancer- A Prospective Cohort Study

Abstract
BACKGROUND/AIM:
Interest of gastric cancer patients in the quality of life postoperatively with respect to reduced scarring is increasing. This study aimed to evaluate the feasibility of reduced-port totally laparoscopic gastrectomy (RepTLG) for the treatment of gastric cancer.

METHODS:
In total, 170 patients who underwent RepTLG (n = 97) or conventional totally laparoscopic gastrectomy (cTLG) (n = 73) were enrolled. Clinicopathological features, operative details, and short-term postoperative outcomes were analyzed retrospectively and compared between groups.

RESULTS:
There were no significant differences for preoperative comorbidity between the RepTLG and c TLG groups, although patients in the RepTLG group were older than those in the cTLG group (63.5 ± 11.1 vs. 59.3 ± 10.6; p = 0.014). Operating time was shorter in the RepTLG group compared to the cTLG group (187.5 ± 67.7 min vs. 219.6 ± 43.3 min; p < 0.001) and duration of flatus of the RepTLG group was shorter than that of the cTLG group (2.7 ± 0.6 days vs. 2.9 ± 0.8 days; p = 0.016).

CONCLUSION:
RepTLG is a reliable scar reducing method with good operative and short-term outcomes for the treatment of gastric cancer compared with cTLG.

KEYWORDS:
Gastrectomy; Laparoscopic surgery; Minimal invasive surgery; Stomach neoplasm; Surgical instruments

Is the 5-ports approach necessary in laparoscopic gastrectomy- Feasibility of reduced-port totally l ...

Fig. 1. Port location according to each technique. (a) 3-port reduced-port totally laparoscopic gastrectomy (RepTLG) (12 mm in the umbilical area, 12 mm in the RLQ area and 5 mm in the RUQ area), (a) t (b) 4-port RepTLG (3-port RepTLG ports and 5 mm in the LLQ area), (a) t (b) t (c) conventional totally laparoscopic gastrectomy (4- port RepTLG ports and 5 mm in the LUQ area).

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