Journal of Gastric Cancer

  • 제25권2호
  • /
  • Pages.330-342
  • /
  • 2025
  • /
  • 2093-582X(pISSN)
  • /
  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Reduced Port Gastrectomy and Multiport Gastrectomy in Korea: Ad Hoc Analysis and Nationwide Survey on Gastric Cancer 2019

  • 투고 : 2024.08.04
  • 심사 : 2024.11.20
  • 발행 : 2025.04.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study aimed to evaluate the outcomes and current status of reduced-port laparoscopic distal gastrectomy (RLDG) compared with multiport laparoscopic distal gastrectomy (MLDG) based on a 2019 nationwide survey of surgical gastric cancer treatments by the Korean Gastric Cancer Association (KGCA). Materials and Methods: The study was conducted retrospectively from March to December 2020 using data from the 2019 KGCA nationwide survey database. To compare RLDG and MLDG based on age, sex, body mass index, American Society of Anesthesiologists score, histological type, tumor invasion, and lymph node metastasis, propensity score matching was performed. Results: Of the 14,076 registered patients with gastric cancer, the five-port approach was the most favored for multiport gastrectomy, accounting for 6,396 (70.9%) cases, followed by the four-port approach, with 1,462 (16.2%) cases. The single-port approach was used in 303 (3.4%) cases, the two-port approach in 95 (1.1%) cases, and the three-port approach in 731 (8.1%) cases. RLDG was performed in 805 patients (6.4%), MLDG was conducted in 4,831 patients (34.3%), and 804 patients were 1:1 matched in each group. The average operation time was shorter in the RLDG (168.2±49.1 min vs. 179.5±61.5 min, P<0.001). No significant difference was found in blood loss (84.8±115.9 cc vs. 75.5±119.6 cc, P=0.152), overall complication rates (11.3% vs. 13.1%, P=0.254), or complications ≥ to grade IIIa (3.2% vs. 4.4%, P=0.240). Conclusions: This study revealed that RLDG is a safe and effective surgical option for gastric cancer with the potential to offer shorter operation times without increasing the risk of complications.

키워드

과제정보

This research was supported by the nationwide survey project of the Information Committee of the Korean Gastric Cancer Association (study number: KGCA2022IC11).

참고문헌

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209-249. https://doi.org/10.3322/caac.21660
  2. Bamboat ZM, Strong VE. Minimally invasive surgery for gastric cancer. J Surg Oncol 2013;107:271-276. https://doi.org/10.1002/jso.23237
  3. Park DJ, Lee JH, Ahn SH, Eng AK, Kim HH. Single-port laparoscopic distal gastrectomy with D1+β lymph node dissection for gastric cancers: report of 2 cases. Surg Laparosc Endosc Percutan Tech 2012;22:e214-e216. https://doi.org/10.1097/SLE.0b013e318253df9b
  4. Omori T, Oyama T, Akamatsu H, Tori M, Ueshima S, Nishida T. Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancer. Surg Endosc 2011;25:2400-2404. https://doi.org/10.1007/s00464-010-1563-3
  5. Omori T, Fujiwara Y, Moon J, Sugimura K, Miyata H, Masuzawa T, 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 2016;23 Suppl 5:817-824. https://doi.org/10.1245/s10434-016-5485-8
  6. Ahn SH, Park DJ, Son SY, Lee CM, Kim HH. Single-incision laparoscopic total gastrectomy with D1+beta lymph node dissection for proximal early gastric cancer. Gastric Cancer 2014;17:392-396. https://doi.org/10.1007/s10120-013-0268-4
  7. Kang SH, Cho YS, Min SH, Park YS, Ahn SH, Do Park J, et al. Intracorporeal overlap gastro-gastrostomy for solo single-incision pylorus-preserving gastrectomy in early gastric cancer. Surg Today 2019;49:1074-1079. https://doi.org/10.1007/s00595-019-01820-x
  8. Kim HG, Kim DY, Jeong O. Transition from conventional to reduced-port laparoscopic gastrectomy to treat gastric carcinoma: a single surgeon's experience from a small-volume center. J Gastric Cancer 2018;18:172-181. https://doi.org/10.5230/jgc.2018.18.e18
  9. Kang SH, Cho YS, Min SH, Park YS, Ahn SH, Park DJ, et al. Early experience and learning curve of solo single-incision distal gastrectomy for gastric cancer: a review of consecutive 100 cases. Surg Endosc 2019;33:3412-3418. https://doi.org/10.1007/s00464-018-06638-1
  10. Park DJ, Lee EJ, Kim GY. Evaluation of reduced port laparoscopic distal gastrectomy performed by a novice surgeon. 1 Gastric Cancer 2021;21:179-190. https://doi.org/10.5230/jgc.2021.21.e20
  11. Kim JW. Current issues in reduced-port gastrectomy: a comprehensive review. I Gastric Cancer 2024;24:57-68. https://doi.org/10.5230/jgc.2024.24.e9
  12. Kang SH, Lee E, Lee S, Park YS, Ahn SH, Park DJ, et al. Long-term outcomes of single-incision distal gastrectomy compared with conventional laparoscopic distal gastrectomy: a propensity score-matched analysis. I Am Coll Surg 2022:234:340-351. https://doi.org/10.1097/XCS.0000000000000052
  13. Omori T, Yamamoto K, Hara H, Shinno N, Yamamoto M, Sugimura K, et al. A randomized controlled trial of single-port versus multi-port laparoscopic distal gastrectomy for gastric cancer. Surg Endosc 2021;35:4485-4493. https://doi.org/10.1007/s00464-020-07955-0
  14. Teng W, Liu J, Liu W, Jiang J, Chen M, Wei C, et al. Comparison of short-term outcomes between single-incision plus one-port laparoscopic surgery and conventional laparoscopic surgery for distal gastric cancer: a randomized controlled trial. Transl Cancer Res 2022:11:358-366. https://doi.org/10.21037/tcr-21-1916
  15. Moon KW. Web-Based Analysis without R in Your Computer. Seoul: Hannare, 2015.
  16. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205-213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
  17. Service WHIRaA. Health Insurance Review and Assessment Service. The results of the 5th adequacy evaluation of stomach cancer [Internet]: Wonju: Health Insurance Review and Assessment Service; 2021 [cited 2024 Aug4]. Available from: https://www.hira.or.kr/re/diag/asmWrptPopup.do2evlCd=24&pgmid-HIRAA030004000000.
  18. Information Committee of the Korean Gastric Cancer Association. Korean Gastric Cancer Association-Led Nationwide Survey on Surgically Treated Gastric Cancers in 2019. T Gastric Cancer 2021.21: 221-235. https://doi.org/10.5230/jgc.2021.21.e27
  19. Kim SM, Ha MH, Seo JE, Kim JE, Choi MG, Sohn TS, et al. Comparison of reduced port totally laparoscopic distal gastrectomy (duettldg) and conventional laparoscopic-assisted distal gastrectomy. Ann Surg Oncol 2015;22:2567-2572. https://doi.org/10.1245/s10434-014-4333-y
  20. Oh SD, Oh SJ. Three-port versus five-port laparoscopic distal gastrectomy for early gastric cancer patients: a propensity score matched case-control study. J Invest Surg 2018:31:455-463. https://doi.org/10.1080/08941939.2017.1355941
  21. Seo HS, Song KY, Jung YJ, Kim JH, Park CH, Lee HH. Right-side approach-duet totally laparoscopic distal gastrectomy (R-duet TLDG) using a three-port to treat gastric cancer. J Gastrointest Surg 2018;22:578-586. https://doi.org/10.1007/s11605-017-3575-y
  22. Kim KH, Lee SH, Choi CW, Kim SJ, Choi CI, Kim DH, et al. Actual 3-year survival after reduced-port laparoscopic distal gastrectomy for gastric cancer (RpLDG): a propensity score matching analysis.] Gastrointest Surg 2022;26:550-557. https://doi.org/10.1007/s11605-021-05097-9
  23. Kunisaki C, Miyamoto H, Sato S, Tanaka Y, Sato K, Izumisawa Y, et al. Surgical outcomes of reduced-port laparoscopic gastrectomy versus conventional laparoscopic gastrectomy for gastric cancer: a propensity-matched retrospective cohort study. Ann Surg Oncol 2018:25:3604-3612. https://doi.org/10.1245/s10434-018-6733-x
  24. Du GS, Jiang EL, Qiu Y, Wang WS, Yin JH, Wang S, et al. Single-incision plus one-port laparoscopic gastrectomy versus conventional multi-port laparoscopy-assisted gastrectomy for gastric cancer: a retrospective study. Surg Endosc 2022;36:3298-3307. https://doi.org/10.1007/s00464-021-08643-3
  25. Doden K, Inaki N, Tsuji T, Matsui R. Needle device-assisted single-incision laparoscopic gastrectomy for early gastric cancer: a propensity score-matched analysis. Asian J Endosc Surg 2021;14:511-519. https://doi.org/10.1111/ases.12909