Oh Sung Don, Oh Sung Jin
a Department of Surgery, Haeundae Paik Hospital , Inje University College of Medicine , Busan , Korea.
J Invest Surg. 2018 Dec;31(6):455-463. doi: 10.1080/08941939.2017.1355941. Epub 2017 Aug 22.
The aim of this study was to evaluate the feasibility and safety of three-port laparoscopic distal gastrectomy (TP-LDG) as a reduced port laparoscopic gastrectomy.
We retrospectively identified 146 patients preoperatively diagnosed with early gastric cancer who underwent five-port laparoscopic distal gastrectomy (FP-LDG) or TP-LDG between May 2013 and July 2016. A propensity score matching analysis was used to create patient groups (48 patients in each group) matched for sex, age, body mass index, previous abdominal surgery history, and American Society of Anesthesiologist score. The short-term surgical outcomes between TP-LDG and FP-LDG were compared.
The TP-LDG group had a statistically shorter umbilical wound length [3.4 (range, 3.0-4.0) cm vs. 3.9 (range, 3.7-4.0) cm, p = .000], shorter operative time [230 (range, 190-310) min vs. 250 (range, 180-320) min, p = .036], and lower estimated blood loss [68 (range, 20-180) mL vs. 80 (range, 40-150) mL, p = .005] compared to that in the FP-LDG group. However, there was no specific superiority regarding inflammatory profiles. Complication rates were also similar (8.4% TP-LDG vs. 12.6% FP-LDG, p = .504).
TP-LDG is a feasible and safe surgical procedure for the patients with early gastric cancer and provides the benefit of better cosmesis.
本研究旨在评估三孔腹腔镜远端胃癌切除术（TP-LDG）作为一种减少端口的腹腔镜胃癌切除术的可行性和安全性。
我们回顾性分析了2013年5月至2016年7月期间146例术前诊断为早期胃癌并接受五孔腹腔镜远端胃癌切除术（FP-LDG）或TP-LDG的患者。采用倾向评分匹配分析，以创建在性别、年龄、体重指数、既往腹部手术史和美国麻醉医师协会评分方面相匹配的患者组（每组48例患者）。比较了TP-LDG和FP-LDG之间的短期手术结果。
与FP-LDG组相比，TP-LDG组的脐部伤口长度在统计学上更短[3.4（范围，3.0 - 4.0）cm对3.9（范围，3.7 - 4.0）cm，p = 0.000]，手术时间更短[230（范围，190 - 310）分钟对250（范围，180 - 320）分钟，p = 0.036]，估计失血量更低[68（范围，20 - 180）mL对80（范围，40 - 150）mL，p = 0.005]。然而，在炎症指标方面没有特定优势。并发症发生率也相似（TP-LDG组为8.4%，FP-LDG组为12.6%，p = 0.504）。
TP-LDG对于早期胃癌患者是一种可行且安全的手术方法，并且具有更好的美容效果。
