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Long-Term Oncological Outcomes of Reduced Three-Port Laparoscopic Gastrectomy for Early-Stage Gastric Carcinoma: a Retrospective Large-Scale Multi-Institutional Study

Journal of Gastric Cancer 2021년 21권 1호 p.93 ~ 102
이한홍, 정오, 서호석, 최민규, 류성엽, 손태성, 배재문, 김성, 이준호,
소속 상세정보
이한홍 ( Lee Han-Hong ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Surgery
정오 ( Jeong Oh ) - Chonnam National University Medical School Department of Surgery
서호석 ( Seo Ho-Seok ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Surgery
최민규 ( Choi Min-Gew ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
류성엽 ( Ryu Seong-Yeob ) - Chonnam National University Medical School Department of Surgery
손태성 ( Sohn Tae-Sung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
배재문 ( Bae Jae-Moon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
김성 ( Kim Sung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
이준호 ( Lee Jun-Ho ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery

Abstract


Purpose: With advances in surgical techniques, reduced-port laparoscopic surgery is increasingly being performed for the treatment of gastric carcinoma. Many studies have reported satisfactory short-term outcomes after reduced 3-port laparoscopic gastrectomy (LG). The aim of this study was to investigate the long-term oncological outcomes of 3-port LG in patients with gastric carcinoma.

Materials and Methods: We reviewed the medical records of 1,117 patients who underwent LG for gastric carcinoma in three major institutions between 2012 and 2015. The data showed that 460 patients underwent 3-port LG without assistance, and 657 underwent conventional 5-port LG. We compared the overall and disease-free survival rates between the 2 groups.

Results: There were 642 male and 475 female patients with a mean age of 56.1 years. Among them, 1,028 (92.0%) underwent distal gastrectomy and 89 (8.0%) underwent total gastrectomy. In the final pathologic examination, 1,027 patients (91.9%) were stage I, 73 (6.5%) were stage II, and 17 (1.5%) were stage III, and there were no significant difference in the pathologic stage between groups. The 3- and 5-port LG groups showed no significant differences in the 5-year overall survival (94.3% vs. 96.7%, P=0.138) or disease-free survival (94.3% vs. 95.9%, P=0.231). Stratified analyses according to pT and pN stages also showed no significant differences in overall or disease-free survival between the two groups.

Conclusions: Long-term survival after 3- and 5-port LG was comparable in patients with early-stage gastric carcinoma. The 3-port technique requiring limited surgical assistance may be an appropriate surgical option for this patient population.

키워드

Gastrectomy; Laparoscopy; Reduced port surgery; Stomach neoplasm; Survival

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