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Surgical Endoscopy
Published in: Surgical Endoscopy 12/2016

01-12-2016

Surgical advantages of reduced-port laparoscopic gastrectomy in gastric cancer

Authors: Chikara Kunisaki, Hirochika Makino, Naotaka Yamaguchi, Yusuke Izumisawa, Hiroshi Miyamato, Kei Sato, Tsutomu Hayashi, Nobuhiro Sugano, Yoshihiro Suzuki, Mitsuyoshi Ota, Akira Tsuburaya, Jun Kimura, Ryo Takagawa, Takashi Kosaka, Hidetaka Andrew Ono, Hirotoshi Akiyama, Itaru Endo

Published in: Surgical Endoscopy | Issue 12/2016

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Abstract

Background

Although a few studies have reported the use of reduced-port laparoscopic gastrectomy (RPG) in gastric cancer patients, the feasibility of routinely using this technique remains unclear. It is therefore important to evaluate the surgical advantages of this technique in this patient group.

Methods

Between August 2010 and July 2015, 165 patients underwent RPGs at our hospital, performed by a single surgeon. Of these patients, 88 underwent reduced-port laparoscopic distal gastrectomy (RPLDG) and 77 underwent reduced-port laparoscopic total gastrectomy (RPLTG). In addition to short-term surgical outcomes after RPG, survival times and the surgical learning curve were also evaluated.

Results

Blood losses during lymph node dissection in the RPLDG and RPLTG groups were not significantly different (p = 0.160). Conversion to open surgery was necessary in only two patients. Postoperative morbidities were observed in 14.8 % of the RPLDG group and 14.3 % of the RPLTG group, but there were no deaths. Most patients expressed high cosmetic satisfaction in both groups. In the RPLDG group, operation time during reconstruction decreased over the first 50 cases and then plateaued, as the surgeon’s experience of the technique increased. In contrast, in the RPLTG group, operation times dropped with surgical experience for both lymph node dissection, plateauing after 40 cases, and for reconstruction, plateauing after 30 cases. Only three patients died of gastric cancer in the follow-up period and three patients died of other diseases. Five-year overall survival and 5-year disease-specific survival were 95.6 and 98.0 %, respectively.

Conclusions

We have shown that reduced-port gastrectomy (RPG) could be an acceptable and satisfactory procedure for treating gastric cancer for an experienced laparoscopic gastric surgeon who has sufficient previous experience of conventional laparoscopic gastrectomies.
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Metadata
Title
Surgical advantages of reduced-port laparoscopic gastrectomy in gastric cancer
Authors
Chikara Kunisaki
Hirochika Makino
Naotaka Yamaguchi
Yusuke Izumisawa
Hiroshi Miyamato
Kei Sato
Tsutomu Hayashi
Nobuhiro Sugano
Yoshihiro Suzuki
Mitsuyoshi Ota
Akira Tsuburaya
Jun Kimura
Ryo Takagawa
Takashi Kosaka
Hidetaka Andrew Ono
Hirotoshi Akiyama
Itaru Endo
Publication date
01-12-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 12/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-4916-8

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