Three-Port Versus Five-Port Laparoscopic Distal Gastrectomy for Early Gastric Cancer Patients: A Propensity Score Matched Case-Control Study

Abstract

Aim: The aim of this study was to evaluate the feasibility and safety of three-port laparoscopic distal gastrectomy (TP-LDG) as a reduced port laparoscopic gastrectomy. Materials and Methods: We retrospectively identified 146 patients preoperatively diagnosed with early gastric cancer who underwent five-port laparoscopic distal gastrectomy (FP-LDG) or TP-LDG between May 2013 and July 2016. A propensity score matching analysis was used to create patient groups (48 patients in each group) matched for sex, age, body mass index, previous abdominal surgery history, and American Society of Anesthesiologist score. The short-term surgical outcomes between TP-LDG and FP-LDG were compared. Results: The TP-LDG group had a statistically shorter umbilical wound length [3.4 (range, 3.0–4.0) cm vs. 3.9 (range, 3.7–4.0) cm, p =.000], shorter operative time [230 (range, 190–310) min vs. 250 (range, 180–320) min, p =.036], and lower estimated blood loss [68 (range, 20–180) mL vs. 80 (range, 40–150) mL, p =.005] compared to that in the FP-LDG group. However, there was no specific superiority regarding inflammatory profiles. Complication rates were also similar (8.4% TP-LDG vs. 12.6% FP-LDG, p =.504). Conclusions: TP-LDG is a feasible and safe surgical procedure for the patients with early gastric cancer and provides the benefit of better cosmesis.