Clinical efficacy of single-port plus one-port laparoscopic radical gastrectomy: a short-term analysis

Abstract

Objective To compare the short-term efficacy and stress indexes in patients after radical gastric cancer surgery between single-port plus one-port (SILS+1) laparoscope and traditional five-port laparoscope based on enhanced recovery after surgery (ERAS). Methods A total of 114 patients who underwent laparoscopic radical gastrectomy in our department from March 2017 to July 2019 were recruited in this ERAS study. According the surgical approach, they were divided into SILS+1 group (n=66) and traditional laparoscopic group (n=48). The levels of white blood cell count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT) and interleukin-6 (IL-6) at 1, 3 and 5 d after surgery were recorded and compared between the 2 groups. What's more, operation time, incision length, intraoperative blood loss, tumor type and TNM stage were compared between the 2 groups, and the time of gastric tube removal, time of first feeding, time of first movement out of bed, time of first anal exhaust, time of first defecation and time of postoperative hospitalization were recorded. Results ① There were no statistically significant differences in age, sex, BMI and tumor stage, or in WBC, CRP, ESR, PCT and IL-6 levels in 1 d before surgery between the 2 groups (P>0.05). ② The SILS+1 laparoscopic group had significantly longer operation time than the traditional laparoscopic group (P 0.05). Conclusion Under the concept of ERAS, although SILS+1 laparoscope prolongs the operation time when compared with the traditional five-port laparoscope, it can obtain better short-term clinical efficacy, and is helpful to reduce the stress responses and promote the early recovery in the patients after radical gastric cancer surgery.

Keywords

• enhanced recovery after surgery
• gastric cancer
• sils +1 laparoscopic surgery
• stress indicators