title: Comparison of Single-Incision and Conventional Multi-Port Laparoscopic Distal Gastrectomy with D2 Lymph Node Dissection for Gastric Cancer: A Propensity Score-Matched Analysis.
abstract: Single-incision laparoscopic surgery maximizes the advantages of laparoscopic surgery by reducing abdominal trauma; however, few comparative studies have addressed its role in gastric cancer.
  
  
  
  This study sought to demonstrate the safety and feasibility of single-incision laparoscopic distal gastrectomy (SLDG) with radical D2 lymphadenectomy by comparing its short- and long-term outcomes with those of conventional multi-port laparoscopic surgery (MLDG).
  
  
  
  From October 2007 to December 2011, we identified 175 patients with clinical stage I-III gastric cancer who underwent SLDG with D2 lymphadenectomy (n = 90) and MLDG (n = 85) according to a review of our prospective gastric cancer database in our institute. One-to-one propensity score matching was performed to compare short-term outcomes and long-term survival between the two groups.
  
  
  
  Mean operative time was similar between the two groups, while blood loss was significantly lower in the SLDG group than in the MLDG group. Postoperative recovery was faster in the SLDG group in terms of earlier initiation of oral intake, less use of analgesics, and shorter hospital stay. Serum C-reactive protein levels were significantly lower in the SLDG group than in the MLDG group on postoperative days 1, 3, and 7, and the 5-year overall survival rate was not significantly different between the two groups (93.7 vs. 87.6 %; p = 0.689).
  
  
  
  This study shows that SLDG with D2 lymphadenectomy is safe and feasible for gastric cancer, with better short-term outcomes than MLDG and acceptable oncologic outcomes. Thus, SLDG may be an attractive surgical alternative in minimally invasive surgery.
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. oomori-ta@mc.pref.osaka.jp.
authors: Takeshi
authors: T
authors: Omori
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Yoshiyuki
authors: Y
authors: Fujiwara
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: JeongHo
authors: J
authors: Moon
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Keijiro
authors: K
authors: Sugimura
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Hiroshi
authors: H
authors: Miyata
authors: Department of Surgery, Osaka Police Hospital, Osaka, Japan.
authors: Toru
authors: T
authors: Masuzawa
authors: Department of Surgery, Osaka Police Hospital, Osaka, Japan.
authors: Kentaro
authors: K
authors: Kishi
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Norikatsu
authors: N
authors: Miyoshi
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Akira
authors: A
authors: Tomokuni
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Hirofumi
authors: H
authors: Akita
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Hidenori
authors: H
authors: Takahashi
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Syougo
authors: S
authors: Kobayashi
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Masayoshi
authors: M
authors: Yasui
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Masayuki
authors: M
authors: Ohue
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Masahiko
authors: M
authors: Yano
authors: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Masato
authors: M
authors: Sakon
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D016063:Blood Loss, Surgical; D002097:C-Reactive Protein / Q000378:metabolism; D004435:Eating; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011184:Postoperative Period; D057216:Propensity Score; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate
chemical_list: D000700:Analgesics; D002097:C-Reactive Protein