Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3786-3793
Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3786
Comparative analysis of conventional laparoscopic surgery and single-incision laparoscopic surgery in gastric cancer treatment: Outcomes and prognosis
Ce Cao, Xue Tian, Xue-Zhao Wang, Qing Wang
Ce Cao, Department of Gastrointestinal Surgery, Zibo Central Hospital, Zibo 255036, Shandong Province, China
Xue Tian, Department of Oncology, Zibo Central Hospital, Zibo 255036, Shandong Province, China
Xue-Zhao Wang, Department of Urology Surgery, Zibo Central Hospital, Zibo 255036, Shandong Province, China
Qing Wang, Department of Hepatobiliary Surgery, Zibo Central Hospital, Zibo 255036, Shandong Province, China
Author contributions: Cao C and Wang Q designed the study, performed the experiments and prepared the manuscript; Tian X collected the data; Wang XZ analyzed the data; All authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the ethics committee of Zibo Central Hospital.
Informed consent statement: Signed written informed consents were obtained from the patients and/or guardians.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing Wang, MD, Doctor, Department of Hepatobiliary Surgery, Zibo Central Hospital, No. 54 Gongqingtuan West Road, Zhangdian District, Zibo 255036, Shandong Province, China. egx550@126.com
Received: August 26, 2024
Revised: September 20, 2024
Accepted: October 22, 2024
Published online: December 27, 2024
Processing time: 92 Days and 17.1 Hours
Abstract
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 (n = 56) and CLS group (n = 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, P < 0.001), and the total incision length was also significantly shorter in the SILS + 1 group (5.29 ± 1.01 cm vs 9.45 ± 2.34 cm, P < 0.001). SILS + 1 patients experienced faster recovery, with shorter times to first flatus (1.94 ± 0.43 days vs 3.23 ± 0.88 days, P < 0.001) and ambulation (2.76 ± 0.58 days vs 4.10 ± 0.97 days, P < 0.001). Postoperative pain, as measured by VAS scores, was significantly lower in the SILS + 1 group on postoperative days 1, 2, and 3 (P < 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 vs 7.82 ± 1.88 mg/L, P < 0.001; WBC: 6.34 ± 1.50 × 109/L vs 7.09 ± 1.61 × 109/L, P = 0.024). The complication rate in the SILS + 1 group was also significantly lower than in the CLS group (8.93% vs 27.03%, P = 0.020). However, there was no significant difference in recurrence rates between the two groups after one year (3.57% vs 8.11%, P > 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.

Keywords: Single-incision laparoscopic surgery + 1 port; Conventional laparoscopic surgery; Radical gastrectomy; Gastric cancer; Recurrence

Core Tip: This study compares the effects of single-incision laparoscopic surgery plus one port (SILS + 1) and conventional laparoscopic surgery (CLS) in treating gastric cancer. SILS + 1 was found to reduce intraoperative blood loss, relieve postoperative pain, and lower stress response, leading to quicker recovery and fewer complications. Both techniques showed comparable lymph node clearance and no difference in recurrence rate after one year. SILS + 1 offers a minimally invasive option with enhanced safety and recovery benefits, making it a promising alternative to CLS for gastric cancer patients.