Comparative analysis of conventional laparoscopic surgery and single-incision laparoscopic surgery in gastric cancer treatment: Outcomes and prognosis.

BACKGROUND

Gastric cancer surgery has advanced with minimally invasive techniques. This study compares outcomes between single-incision laparoscopic surgery plus one port (SILS + 1) and conventional laparoscopic surgery (CLS) in treating gastric cancer.

AIM

To explore the curative effect of SILS + 1 and CLS on gastric cancer and their influences on prognosis.

METHODS

A total of 93 patients with gastric cancer undergoing radical gastrectomy in the hospital were retrospectively analyzed between September 2019 and September 2022. According to different surgical methods, they were divided into SILS + 1 group ( = 56) and CLS group ( = 37). The perioperative indexes, pain degree [visual analogue scale (VAS)] and stress response [C-reactive protein (CRP), white blood cell count (WBC)] in the two groups were compared. The postoperative complications, recurrence rate and mortality at 1 year after surgery were recorded.

RESULTS

Intraoperative blood loss was significantly lower in the SILS + 1 group (76.53 ± 8.12 mL) compared to the CLS group (108.67 ± 12.34 mL, < 0.001), and the total incision length was also significantly shorter in the SILS + 1 group (5.29 ± 1.01 cm 9.45 ± 2.34 cm, < 0.001). SILS + 1 patients experienced faster recovery, with shorter times to first flatus (1.94 ± 0.43 days 3.23 ± 0.88 days, < 0.001) and ambulation (2.76 ± 0.58 days 4.10 ± 0.97 days, < 0.001). Postoperative pain, as measured by VAS scores, was significantly lower in the SILS + 1 group on postoperative days 1, 2, and 3 ( < 0.001). Additionally, stress markers (CRP and WBC) were significantly lower in the SILS + 1 group on the first postoperative day (CRP: 6.41 ± 1.63 mg/L 7.82 ± 1.88 mg/L, < 0.001; WBC: 6.34 ± 1.50 × 10/L 7.09 ± 1.61 × 10/L, = 0.024). The complication rate in the SILS + 1 group was also significantly lower than in the CLS group (8.93% 27.03%, = 0.020). However, there was no significant difference in recurrence rates between the two groups after one year (3.57% 8.11%, > 0.05).

CONCLUSION

SILS + 1 and CLS have the comparable lymph node clearance effect in patients with gastric cancer. However, SILS + 1 is more beneficial to reduce intraoperative blood loss, relieve pain, alleviate stress response, reduce the incidence of complications and promote rapid postoperative recovery.