Hwang Duyeong, Yoo Mira, Min Guan Hong, Lee Eunju, Kang So Hyun, Park Young Suk, Ahn Sang-Hoon, Kim Hyung-Ho, Suh Yun-Suhk
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Surgery, Dongguk University College of Medicine, Goyang, Korea.
J Gastric Cancer. 2025 Apr;25(2):330-342. doi: 10.5230/jgc.2025.25.e15.
This study aimed to evaluate the outcomes and current status of reduced-port laparoscopic distal gastrectomy (RLDG) compared with multiport laparoscopic distal gastrectomy (MLDG) based on a 2019 nationwide survey of surgical gastric cancer treatments by the Korean Gastric Cancer Association (KGCA).
The study was conducted retrospectively from March to December 2020 using data from the 2019 KGCA nationwide survey database. To compare RLDG and MLDG based on age, sex, body mass index, American Society of Anesthesiologists score, histological type, tumor invasion, and lymph node metastasis, propensity score matching was performed.
Of the 14,076 registered patients with gastric cancer, the five-port approach was the most favored for multiport gastrectomy, accounting for 6,396 (70.9%) cases, followed by the four-port approach, with 1,462 (16.2%) cases. The single-port approach was used in 303 (3.4%) cases, the two-port approach in 95 (1.1%) cases, and the three-port approach in 731 (8.1%) cases. RLDG was performed in 805 patients (6.4%), MLDG was conducted in 4,831 patients (34.3%), and 804 patients were 1:1 matched in each group. The average operation time was shorter in the RLDG (168.2±49.1 min vs. 179.5±61.5 min, P0.001). No significant difference was found in blood loss (84.8±115.9 cc vs. 75.5±119.6 cc, 0.152), overall complication rates (11.3% vs. 13.1%, P=0.254), or complications ≥ to grade IIIa (3.2% vs. 4.4%, P=0.240).
This study revealed that RLDG is a safe and effective surgical option for gastric cancer with the potential to offer shorter operation times without increasing the risk of complications.
本研究旨在基于韩国胃癌协会（KGCA）2019年全国性胃癌手术治疗调查，评估与多端口腹腔镜远端胃切除术（MLDG）相比，减少端口腹腔镜远端胃切除术（RLDG）的治疗效果和现状。
本研究于2020年3月至12月进行回顾性研究，使用2019年KGCA全国性调查数据库中的数据。为了基于年龄、性别、体重指数、美国麻醉医师协会评分、组织学类型、肿瘤浸润和淋巴结转移情况比较RLDG和MLDG，进行了倾向得分匹配。
在14076例登记的胃癌患者中，五端口法是多端口胃切除术中最常用的方法，占6396例（70.9%），其次是四端口法，有1462例（16.2%）。单端口法用于303例（3.4%），双端口法用于95例（1.1%），三端口法用于731例（8.1%）。805例患者接受了RLDG（6.4%），4831例患者接受了MLDG（34.3%），每组804例患者进行了1:1匹配。RLDG组的平均手术时间较短（168.2±49.1分钟对179.5±61.5分钟，P<0.001）。在失血量（84.8±115.9毫升对75.5±119.6毫升，P=0.152）、总体并发症发生率（11.3%对13.1%，P=0.254）或≥IIIa级并发症（3.2%对4.4%，P=0.240）方面未发现显著差异。
本研究表明，RLDG是一种安全有效的胃癌手术选择，有可能缩短手术时间，且不增加并发症风险。
