Safety and feasibility of single-incision laparoscopic distal gastrectomy in overweight and obese gastric cancer patients: a propensity score-matched analysis

• Published in: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 27; no. 5; pp. 1136 - 1146
• Main Authors: Lee, Eunju, Suh, Yun-Suhk, Yoo, Mira, Hwang, Duyeong, Kang, So Hyun, Lee, Sangjun, Park, Young Suk, Ahn, Sang-Hoon, Kong, Seong-Ho, Park, Do Joong, Lee, Hyuk-Joon, Kim, Hyung-Ho, Yang, Han-Kwang
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.09.2024; Springer Nature B.V
• Subjects: Abdominal Surgery; Adenocarcinoma; Adenocarcinoma - complications; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Aged; Anastomosis; Body mass index; Body weight; Cancer Research; Complications; Feasibility Studies; Female; Gastrectomy; Gastrectomy - methods; Gastric cancer; Gastroenterology; Gastrointestinal surgery; Humans; Laparoscopy; Laparoscopy - methods; Length of Stay; Lymph nodes; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity - complications; Obesity - surgery; Oncology; Operative Time; Original; Original Article; Overweight; Overweight - complications; Pathology; Patients; Postoperative; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative period; Propensity Score; Retrospective Studies; Sex ratio; Stomach Neoplasms - complications; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgical Oncology; Surgical outcomes; Obesity; Stomach Neoplasms; Gastrectomy; Minimally Invasive Surgical Procedures
• ISSN: 1436-3291; 1436-3305; 1436-3305
• DOI: 10.1007/s10120-024-01530-5

Background The technical challenges and safety concerns of single-incision laparoscopic gastrectomy for overweight and obese gastric cancer patients remain unclear. This study aimed to evaluate the safety and feasibility of single-incision laparoscopic distal gastrectomy (SIDG) compared to multiport laparoscopic distal gastrectomy (MLDG) in overweight and obese gastric cancer patients. Methods This study retrospectively analyzed overweight and obese patients (body mass index ≥ 25 kg/m 2 ) and pathologic stage T1 primary gastric adenocarcinoma treated with either SIDG or MLDG. The SIDG and MLDG groups were propensity score matched at a 1:2 ratio using age, sex, height, body weight, American Society of Anesthesiologists classification, year of surgery, pathologic N stage, and anastomosis method as covariates. Results After 1:2 matching, the study included patients who underwent SIDG (n = 179) and MLDG (n = 358). No significant difference in the number of retrieved lymph nodes was found between the SIDG and MLDG groups (52.8 ± 19.3 vs. 53.9 ± 21.0, P  = 0.56). Operation times were significantly shorter in the SIDG group (170.8 ± 60.0 min vs. 186.1 ± 52.6 min, P  = 0.004). The postoperative hospital length of stay was comparable between the 2 groups (SIDG: 5.9 ± 3.4 days vs. MLDG: 6.3 ± 5.1 days, P  = 0.23), as was postoperative complication rate (SIDG: 13.4% vs. MLDG: 12.8%, P  = 0.89). Conclusions SIDG was shown to be as safe and feasible as MLDG for overweight and obese gastric cancer patients, with comparable early postoperative complication rates without compromising operation time compared to MLDG.