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

Ahn, Sang-Hoon; Son, Sang‐Yong; Jung, Do Hyun; Park, Do Joong; Kim, Hyung‐Ho

doi:10.1016/j.jamcollsurg.2014.07.009

Cited by 71 publications

(57 citation statements)

References 24 publications

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“…However, some studies addressed the feasibility and safety of single-port gastrectomy (SIESG). Three comparative studies were found in which laparoscopic single-port distal gastrectomy for early gastric cancer was compared to multi-port (or reduced port) laparoscopic gastrectomy (MLDG) [141–143]. All studies reported on early gastric cancer, stage Ia/Ib, in patients with BMI < 25 kg/m 2 .…”

Section: Resultsmentioning

confidence: 99%

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

et al. 2019

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BackgroundLaparoscopic surgery changed the management of numerous surgical conditions. It was associated with many advantages over open surgery, such as decreased postoperative pain, faster recovery, shorter hospital stay and excellent cosmesis. Since two decades single-incision endoscopic surgery (SIES) was introduced to the surgical community. SIES could possibly result in even better postoperative outcomes than multi-port laparoscopic surgery, especially concerning cosmetic outcomes and pain. However, the single-incision surgical procedure is associated with quite some challenges.MethodsAn expert panel of surgeons has been selected and invited to participate in the preparation of the material for a consensus meeting on the topic SIES, which was held during the EAES congress in Frankfurt, June 16, 2017. The material presented during the consensus meeting was based on evidence identified through a systematic search of literature according to a pre-specified protocol. Three main topics with respect to SIES have been identified by the panel: (1) General, (2) Organ specific, (3) New development. Within each of these topics, subcategories have been defined. Evidence was graded according to the Oxford 2011 Levels of Evidence. Recommendations were made according to the GRADE criteria.ResultsIn general, there is a lack of high level evidence and a lack of long-term follow-up in the field of single-incision endoscopic surgery. In selected patients, the single-incision approach seems to be safe and effective in terms of perioperative morbidity. Satisfaction with cosmesis has been established to be the main advantage of the single-incision approach. Less pain after single-incision approach compared to conventional laparoscopy seems to be considered an advantage, although it has not been consistently demonstrated across studies.ConclusionsConsidering the increased direct costs (devices, instruments and operating time) of the SIES procedure and the prolonged learning curve, wider acceptance of the procedure should be supported only after demonstration of clear benefits.

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Section: Resultsmentioning

confidence: 99%

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

et al. 2019

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“…Twos studies comparing SIDG and multi (three or more) port totally laparoscopic distal gastrectomy (TLDG) reported similar operation time and comparable complication rate (16,18). Regarding the oncologic outcome, the numbers of retrieved lymph nodes were similar between SIDG and TLDG in both studies.…”

Section: Outcome and Understandingmentioning

confidence: 97%

“…However, quality of life in SIDG compared to TLDG was not comprehensively evaluated until now. Only regarding postoperative pain, previous two studies reported inconsistent results and difference of VAS score is less than 1 point in even significant result (16,18). In the future, scientific evaluation of QOL will guide us to more reasonable assessment of outcome of this state-of-the art procedure.…”

Section: Outcome and Understandingmentioning

confidence: 98%

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Single incision gastrectomy for gastric cancer

Suh

Lee

Yang

2016

Transl. Gastroenterol. Hepatol.

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Based on rapid development of laparoscopic techniques and instruments, single-incision laparoscopic surgery (SILS) is expected to be the next step of "more" minimally invasive surgery. A few institutions gradually started to report their experience of single incision gastrectomy (SIG) for gastric cancer, but it is still difficult to accept that SIG can be performed as a popular procedure because of its technical difficulty. For wide adoption of SIG, the simplicity, safety and reproducibility of not only lymph node dissection but also reconstruction should be evaluated compared to a conventional procedure. With a thorough understanding of unique characteristics of SILS, single incision distal gastrectomy (SIDG) for early gastric cancer performed by laparoscopic surgeons with advanced technique is expected to have promising potential about excellent cosmesis, comparable morbidity and mortality in carefully selected patients. For appropriate adoption and steady progress of this state-of-the art surgery, scientific evaluation with healthy critics is necessary with new generation of SILS instrument platform.

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“…The feasibility of RPLG seems to be almost established in previous reports (7,11,14,17,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). The median operative time in previous reports was 241.9 minutes (range, 186-302 minutes).…”

Section: Feasibilitymentioning

confidence: 89%

Reduced port laparoscopic gastrectomy for gastric cancer

Inaki¹,

Tsuji²,

Doden³

et al. 2016

Transl. Gastroenterol. Hepatol.

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The use of reduced port laparoscopic surgery (RPS) has become increasingly popular. The concept of RPS includes all procedures derived from various efforts minimizing the invasiveness of surgery, with single-incision laparoscopic surgery (SILS) being the ultimate reduced port technique. Reduced-port laparoscopic gastrectomy (RPLG) for gastric cancer has not yet been fully established and still has issues such as feasibility, oncological validity, training, and education. The short-term results of reported studies are acceptable. However, long-term results that verify positive results or radical cure even in cases of cancer have not yet been published. Patients for whom RPLG is indicated should be selected carefully. Prospective multicenter studies should be conducted to establish RPS as a truly evidence-based practice that addresses not only cosmesis but also the appropriate balance between minimal invasiveness and radical cure.

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

Cited by 71 publications

References 24 publications

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

Single incision gastrectomy for gastric cancer

Reduced port laparoscopic gastrectomy for gastric cancer

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