Needle device-assisted single-incision laparoscopic gastrectomy for early gastric cancer: A propensity score-matched analysis

Abstract

Introduction: Single-incision laparoscopic gastrectomy can be difficult because of complex instrumentation and a limited working angle. We standardized a needle device-assisted single-incision laparoscopic gastrectomy (NA-SILG) procedure for early gastric cancer in 2013. Herein, we present our technique and evaluate it in comparison to the conventional laparoscopic gastrectomy CLG) technique.

Methods: We retrospectively reviewed medical records of 149 patients who underwent a NA-SILG or distal (CLG) for early gastric cancer between January 2013 and August 2016. We performed 1:1 propensity score matching between the two groups.

Results: Eighteen patients who underwent a NA-SILG and 131 who underwent a CLG were included. Almost all patients were in clinical stage IA. Operative times were 216 ± 29.7 minutes and 220 ± 51.7 minutes for the NA-SILG and CLG groups, respectively; the median intraoperative bleeding amounts were 5 mL and 10 mL for the NA-SILG and CLG groups, respectively. The median number of retrieved lymph nodes was 41.5 and 57 for the NA-SILG and CLG groups, respectively. The number of patients needing analgesics was significantly lower in the NA-SILG group (P = .003) than in the CLG group. Neither group had postoperative complications more severe than Clavien-Dindo classification III.

Conclusion: Needle device-assisted SILG is safe and feasible for early gastric cancer treatment in slim figure patients. It has short and long-term outcomes comparable to the CLG but is less invasive and results in less postoperative pain.

Keywords: gastrectomy; laparoscopy; needlescopic surgery.