Skip to main content
Log in

Initial Experience of Dual-Port Laparoscopic Distal Gastrectomy for Gastric Cancer: A Single-Arm Study

  • Original Research
  • Published:
Advances in Therapy Aims and scope Submit manuscript

Abstract

Introduction

Dual-port laparoscopic gastrectomy (DPLG) has been widely performed in recent years for treating gastric cancers. The present study reports our initial experience of dual-port laparoscopic distal gastrectomy (DPLDG).

Methods

From November 2016 to August 2018, 38 consecutive patients underwent DPLDG in our center. The observational outcomes included 30-day morbidity and mortality rates, time to first flatus, time to first oral liquid diet, time to first oral semiliquid diet, time to drainage tube removal, visual analogue scale (VAS) score, postoperative 4-day recovery rate, additional analgesic use, hospital stay and cosmetic benefits.

Results

Mean operative time was 191.6 ± 44.4 min, mean intra-operative blood loss was 39.8 ± 48.7 ml, and the mean number of dissected lymph nodes was 38.3 ± 13.7 nodes. One case was converted to five-port laparoscopic surgery, and no intraoperative complications occurred in any of the cases. The mean time to postoperative first flatus was 45.3 ± 18.0 h. The mean time to intake of an oral liquid diet was 56.7 ± 30.4 h. The mean time to drainage tube removal was 97.9 ± 52.3 h. The mean VAS scores for the 3 days after surgery were 2.3 ± 0.7, 2.0 ± 0.6 and 1.6 ± 0.5, respectively. A total of 81.6% of the enrolled patients met the postoperative 4-day recovery standard, and 15.8% of patients received additional analgesics. The mean postoperative hospital stay was 6.0 ± 2.0 days. No deaths were observed, and the 30-day morbidity rate was 13.2%.

Conclusion

DPLDG is a feasible and safe procedure for experienced surgeons with acceptable short-term outcomes, reduced invasiveness and good cosmetic effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Hu Y, Huang C, Sun Y, Su X, Cao H, Hu J, Xue Y, Suo J, Tao K, He X, Wei H, Ying M, Hu W, Du X, Chen P, Liu H, Zheng C, Liu F, Yu J, Li Z, Zhao G, Chen X, Wang K, Li P, Xing J, Li G. Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer: a randomized controlled trial. J Clin Oncol. 2016;34(12):1350–7. https://doi.org/10.1200/JCO.2015.63.7215.

    Article  PubMed  Google Scholar 

  2. Karthik S, Augustine AJ, Shibumon MM, Pai MV. Analysis of laparoscopic port site complications: a descriptive study. J Minim Access Surg. 2013;9:59–64. https://doi.org/10.4103/0972-9941.110964.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Song T, Kim TJ, Kang HJ, Choi CH, Lee JW, Bae DS, Kim BG. Single-port access laparoscopic surgery using a novel laparoscopic port (Octo-Port). Taiwan J Obstet Gynecol. 2011;50:436–40. https://doi.org/10.1016/j.tjog.2011.10.007.

    Article  PubMed  Google Scholar 

  4. Omori T, Oyama T, Akamatsu H, Tori M, Ueshima S, Nishida T. Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancer. Surg Endosc. 2011;25:2400–4. https://doi.org/10.1007/s00464-010-1563-3.

    Article  PubMed  Google Scholar 

  5. Kunisaki C, Ono HA, Oshima T, Makino H, Akiyama H, Endo I. Relevance of reduced-port laparoscopic distal gastrectomy for gastric cancer: a pilot study. Dig Surg. 2012;29(3):261–8. https://doi.org/10.1159/000341677.

    Article  PubMed  Google Scholar 

  6. Nishimura T, Sakata K, Kondo J, Nagashima Y, Okada T, Nakamura M. Laparoscopic hemi-double stapling and reduced-port laparoscopic distal gastrectomy for gastric cancer. Gan Kagaku Ryoho. 2014;41(12):2220–2 PMID: 25731476.

    Google Scholar 

  7. Inaki N. Reduced port laparoscopic gastrectomy: a review, techniques, and perspective. Asian J Endosc Surg. 2015;8(1):1–10. https://doi.org/10.1111/ases.12163.

    Article  PubMed  Google Scholar 

  8. Kawamura H, Tanioka T, Funakoshi T, Takahashi M. Dual-ports laparoscopy-assisted distal gastrectomy compared with conventional laparoscopy-assisted distal gastrectomy. Surg Laparosc Endosc Percutan Tech. 2011;21(6):429–33. https://doi.org/10.1097/SLE.0b013e318238063c.

    Article  PubMed  Google Scholar 

  9. Kashiwagi H, Kumagai K, Monma E, Nozue M. Dual-port distal gastrectomy for the early gastric cancer. Surg Endosc. 2015;29(6):1321–6. https://doi.org/10.1007/s00464-014-3827-9.

    Article  PubMed  Google Scholar 

  10. Shibao K, Matayoshi N, Sato N, Higure A. Reduced port distal gastrectomy with a multichannel port plus one puncture (POP). Surg Technol Int. 2015;26:92–9.

    PubMed  Google Scholar 

  11. Kunisaki C, Makino H, Yamaguchi N, Izumisawa Y, Miyamato H, Sato K, Hayashi T, Sugano N, Suzuki Y, Ota M, Tsuburaya A, Kimura J, Takagawa R, Kosaka T, Ono HA, Akiyama H, Endo I. Surgical advantages of reduced-port laparoscopic gastrectomy in gastric cancer. Surg Endosc. 2016;30:5520–8. https://doi.org/10.1007/s00464-016-4916-8.

    Article  PubMed  Google Scholar 

  12. Lin T, Mou TY, Hu YF, Liu H, Li TJ, Lu YM, Yu J, Li GX. Reduced port laparoscopic distal gastrectomy with D2 lymphadenectomy. Ann Surg Oncol. 2018;25(1):246. https://doi.org/10.1245/s10434-017-6066-1.

    Article  PubMed  Google Scholar 

  13. Lee Y, Kim HH. Single-incision laparoscopic gastrectomy for gastric cancer. J Gastric Cancer. 2017;17:193–203. https://doi.org/10.5230/jgc.2017.17.e29.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ahn SH, Son SY, Jung DH, Park DJ, Kim HH. Pure single-port laparoscopic distal gastrectomy for early gastric cancer: comparative study with multi-port laparoscopic distal gastrectomy. J Am Coll Surg. 2014;219(5):933–43. https://doi.org/10.1016/j.jamcollsurg.2014.07.009.

    Article  PubMed  Google Scholar 

  15. Ahn SH, Jung DH, Son SY, Park DJ, Kim HH. Pure single-incision laparoscopic D2 lymphadenectomy for gastric cancer: a novel approach to 11p lymph node dissection (midpancreas mobilization). Ann Surg Treat Res. 2014;87(5):279–83. https://doi.org/10.4174/astr.2014.87.5.279.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ozdemir BA, Thomas RL, Soon Y. Single-port laparoscopic subtotal gastrectomy with DIalpha lymphadenectomy. Surg Innov. 2011;18(4):1–4. https://doi.org/10.1177/1553350611400759.

    Article  Google Scholar 

  17. Kodera Y. Reduced port surgery for gastric cancer: another giant leap for mankind? Gastric Cancer. 2013;16(4):457–9. https://doi.org/10.1007/s10120-012-0221-y.14.

    Article  PubMed  Google Scholar 

  18. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13. https://doi.org/10.1097/01.sla.0000133083.54934.ae.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Association Japanese Gastric Cancer. Japanese gastric cancer treatment guidelines 2014 (Ver 4). Gastric Cancer. 2017;20(1):1–19.

    Article  Google Scholar 

  20. Dunker MS, Stiggelbout AM, van Hogezand RA, Ringers J, Griffioen G, Bemelman WA. Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc. 1998;12:1334–40 PMID: 9788857.

    Article  CAS  PubMed  Google Scholar 

  21. Omori T, Fujiwara Y, Moon J, Sugimura K, Miyata H, Masuzawa T, Kishi K, Miyoshi N, Tomokuni A, Akita H, Takahashi H, Kobayashi S, Yasui M, Ohue M, Yano M, Sakon M. Comparison of single-incision and conventional multi-port laparoscopic distal gastrectomy with D2 lymph node dissection for gastric cancer: a propensity score-matched analysis. Ann Surg Oncol. 2016;23:817–24. https://doi.org/10.1245/s10434-016-5485-8.

    Article  PubMed  Google Scholar 

  22. Kim HG, Kim DY, Jeong O. Transition from conventional to reduced-port laparoscopic gastrectomy to treat gastric carcinoma: a single surgeon’s experience from a small-volume center. J Gastric Cancer. 2018;18(2):172–81. https://doi.org/10.5230/jgc.2018.18.e18.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kim SM, Ha MH, Seo JE, Kim JE, Choi MG, Sohn TS, Bae JM, Kim S, Lee JH. Comparison of single-port and reduced-port totally laparoscopic distal gastrectomy for patients with early gastric cancer. Surg Endosc. 2016;30(9):3950–7. https://doi.org/10.1007/s00464-015-4706-8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank the participants of the study.

Funding

This work and the journal's Rapid Service Fee was supported by the State’s Key Project of Research and Development Plan (2017YFC0108300), the National Natural Science Foundation of China (81672446), Guangdong Provincial Science and Technology Key Project (2014A020215014), the National Health and Family Planning Commission of China (201402015), the Southern Medical University Clinical Research Start-Up Project (LC2016ZD003) and the Key Clinical Specialty Discipline Construction Program ([2012]121).

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Yi-Ming Lu, Tian Lin, Yan-Feng Hu, Hao Liu, Ting-Yu Mou, Yu Zhu, Jiang Yu and Guo-Xin Li have nothing to disclose.

Compliance with Ethics Guidelines

This study was conducted in accordance with the 1964 declaration of Helsinki and its later amendments and was approved by the Institutional Review Board of Nanfang Hospital of Southern Medical University. Written informed consent was obtained from all participants for the publication of this work and the use of images within this article.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Guo-Xin Li.

Additional information

Enhanced Digital Features

To view enhanced digital features for this article go to https://doi.org/10.6084/m9.figshare.8561438.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lu, YM., Lin, T., Hu, YF. et al. Initial Experience of Dual-Port Laparoscopic Distal Gastrectomy for Gastric Cancer: A Single-Arm Study. Adv Ther 36, 2342–2350 (2019). https://doi.org/10.1007/s12325-019-01029-x

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12325-019-01029-x

Keywords

Navigation