Department of General and Digestive Surgery, Unit of Innovation in Minimally Invasive Surgery, University Hospital "Virgen del Rocio", University of Seville, Seville, Spain.
Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Rome, Italy.
Minim Invasive Ther Allied Technol. 2022 Apr;31(4):515-524. doi: 10.1080/13645706.2021.1884571. Epub 2021 Feb 18.
The aim is to compare single port surgery (SPS)/reduced port surgery (RPS) versus conventional laparoscopy (CL) for gastrectomy for gastric cancer in terms of intra- and postoperative outcomes.
After a search in Pubmed and Embase, six articles were included. Pooled analysis was used to evaluate the statistically significance for each variable.
Two hundred and thirty-three and 230 patients underwent SPS/RPS and CL, respectively. One hundred and eighty-eight patients and 45 patients underwent subtotal and total gastrectomy, respectively, using the SPS/RPS approach. One hundred and eighty-five patients and 45 patients underwent subtotal and total gastrectomy, respectively, by CL. In 85 patients, an extra trocar was systematically placed at the end of surgery. Statistically significant differences were not observed about preoperative staging. The pooled analysis regarding operative time, blood loss, postoperative complications, number of harvested lymph nodes and postoperative hospital stay showed that the only statistically significant difference between the two approaches is the shorter hospital stay in case of SPS/RPS.
SPS/RPS total or subtotal gastrectomy shows a lower postoperative hospital stay, with comparable operative time, blood loss, early postoperative complication rate and number of harvested lymph nodes in comparison to CL, provided extensive experience in minimally invasive gastrectomy is present. AGC: advanced gastric cancer; BMI: body mass index; CI: confidence interval; CL: conventional laparoscopy; LESS: laparoendoscopic single site; MD: mean difference; NOS: Newcastle-Ottawa Scale; OR: odds ratio; PRISMA: Preferred Reporting Items for Systematic Review and Meta-Analysis; ROBIN-I: Risk Of Bias In Non-randomised Studies - of Interventions; RPS: reduced port surgery; RR: risk ratio; SILS: single incision laparoscopic surgery; SPS: single port surgery; WMD: weighted mean differences.
本研究旨在比较单孔手术（SPS）/减少孔手术（RPS）与传统腹腔镜（CL）治疗胃癌的围手术期结局。
通过在 Pubmed 和 Embase 中检索，共纳入 6 篇文章。使用合并分析评估每个变量的统计学意义。
分别有 233 例和 230 例患者接受了 SPS/RPS 和 CL 治疗。188 例和 45 例患者分别采用 SPS/RPS 方法行胃次全切除术和全胃切除术。185 例和 45 例患者分别采用 CL 行胃次全切除术和全胃切除术。在 85 例患者中，在手术结束时系统地放置了一个额外的 Trocar。术前分期无统计学差异。关于手术时间、出血量、术后并发症、淋巴结清扫数目和术后住院时间的合并分析显示，两种方法之间唯一具有统计学意义的差异是 SPS/RPS 的术后住院时间更短。
SPS/RPS 全胃或胃次全切除术与 CL 相比，具有较短的术后住院时间，手术时间、出血量、早期术后并发症发生率和淋巴结清扫数目相当，但前提是具有丰富的微创胃切除术经验。AGC：晚期胃癌；BMI：体重指数；CI：置信区间；CL：传统腹腔镜；LESS：经脐单孔腹腔镜手术；MD：平均差值；NOS：纽卡斯尔-渥太华量表；OR：比值比；PRISMA：系统评价和荟萃分析的首选报告项目；ROBIN-I：非随机干预研究的偏倚风险；RPS：减少孔手术；RR：风险比；SILS：单切口腹腔镜手术；SPS：单孔手术；WMD：加权均数差。
