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Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis
PURPOSE: Single-incision laparoscopic distal gastrectomy (SIDG) requires experienced camera operators for a stable image. Since it is difficult for skilled camera operators to participate in all SIDG, we began performing solo surgery using mechanical camera holders. We aimed to compare the short-ter...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Surgical Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870426/ https://www.ncbi.nlm.nih.gov/pubmed/33585351 http://dx.doi.org/10.4174/astr.2021.100.2.67 |
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author | Lee, Boram Youn, Sang Il Lee, Kanghaeng Won, Yongjoon Min, Sahong Lee, Yoon Taek Park, Young Suk Ahn, Sang-Hoon Park, Do Joong Kim, Hyung-Ho |
author_facet | Lee, Boram Youn, Sang Il Lee, Kanghaeng Won, Yongjoon Min, Sahong Lee, Yoon Taek Park, Young Suk Ahn, Sang-Hoon Park, Do Joong Kim, Hyung-Ho |
author_sort | Lee, Boram |
collection | PubMed |
description | PURPOSE: Single-incision laparoscopic distal gastrectomy (SIDG) requires experienced camera operators for a stable image. Since it is difficult for skilled camera operators to participate in all SIDG, we began performing solo surgery using mechanical camera holders. We aimed to compare the short-term outcomes and cost between solo SIDG and conventional multiport laparoscopic distal gastrectomy (MLDG) for early gastric cancer (EGC). METHODS: From January 2014 to December 2016, a total of 938 consecutive patients underwent laparoscopic gastrectomy for EGC. Solo SIDG (n = 99) and MLDG patients (n = 198) were selected and 1:2 propensity score matching was done to compare the quality of operation and cost-effectiveness. All solo SIDG was performed by a surgeon using a camera holder, without any assistant. RESULTS: Mean operation time (120 ± 35.3 vs. 178 ± 53.4 minutes, P = 0.001) and estimated blood loss (24.6 ± 47.4 vs. 46.7 ± 66.5 mL, P = 0.001) were significantly lower in the solo SIDG group. Hospital stay, use of analgesics, and postoperative inflammatory markers (WBC, CRP) were similar between the 2 groups. The early (<30 days) complication rate in solo SIDG and MLDG groups was 21.2% and 23.7%, respectively (P = 0.240); the late (≥30 days) complication rate was 7.1% and 11.1%, respectively (P = 0.672). The manpower cost of solo SIDG was significantly lower than that of MLDG (P = 0.001). CONCLUSION: This study demonstrated that solo SIDG performed by experienced laparoscopic surgeons is safe and feasible for EGC. Solo SIDG is expected to be a promising potential treatment for EGC. |
format | Online Article Text |
id | pubmed-7870426 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Korean Surgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-78704262021-02-12 Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis Lee, Boram Youn, Sang Il Lee, Kanghaeng Won, Yongjoon Min, Sahong Lee, Yoon Taek Park, Young Suk Ahn, Sang-Hoon Park, Do Joong Kim, Hyung-Ho Ann Surg Treat Res Original Article PURPOSE: Single-incision laparoscopic distal gastrectomy (SIDG) requires experienced camera operators for a stable image. Since it is difficult for skilled camera operators to participate in all SIDG, we began performing solo surgery using mechanical camera holders. We aimed to compare the short-term outcomes and cost between solo SIDG and conventional multiport laparoscopic distal gastrectomy (MLDG) for early gastric cancer (EGC). METHODS: From January 2014 to December 2016, a total of 938 consecutive patients underwent laparoscopic gastrectomy for EGC. Solo SIDG (n = 99) and MLDG patients (n = 198) were selected and 1:2 propensity score matching was done to compare the quality of operation and cost-effectiveness. All solo SIDG was performed by a surgeon using a camera holder, without any assistant. RESULTS: Mean operation time (120 ± 35.3 vs. 178 ± 53.4 minutes, P = 0.001) and estimated blood loss (24.6 ± 47.4 vs. 46.7 ± 66.5 mL, P = 0.001) were significantly lower in the solo SIDG group. Hospital stay, use of analgesics, and postoperative inflammatory markers (WBC, CRP) were similar between the 2 groups. The early (<30 days) complication rate in solo SIDG and MLDG groups was 21.2% and 23.7%, respectively (P = 0.240); the late (≥30 days) complication rate was 7.1% and 11.1%, respectively (P = 0.672). The manpower cost of solo SIDG was significantly lower than that of MLDG (P = 0.001). CONCLUSION: This study demonstrated that solo SIDG performed by experienced laparoscopic surgeons is safe and feasible for EGC. Solo SIDG is expected to be a promising potential treatment for EGC. The Korean Surgical Society 2021-02 2021-02-01 /pmc/articles/PMC7870426/ /pubmed/33585351 http://dx.doi.org/10.4174/astr.2021.100.2.67 Text en Copyright © 2021, the Korean Surgical Society http://creativecommons.org/licenses/by-nc/4.0/ Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Lee, Boram Youn, Sang Il Lee, Kanghaeng Won, Yongjoon Min, Sahong Lee, Yoon Taek Park, Young Suk Ahn, Sang-Hoon Park, Do Joong Kim, Hyung-Ho Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis |
title | Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis |
title_full | Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis |
title_fullStr | Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis |
title_full_unstemmed | Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis |
title_short | Comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis |
title_sort | comparing the short-term outcomes and cost between solo single-incision distal gastrectomy and conventional multiport totally laparoscopic distal gastrectomy for early gastric cancer: a propensity score-matched analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870426/ https://www.ncbi.nlm.nih.gov/pubmed/33585351 http://dx.doi.org/10.4174/astr.2021.100.2.67 |
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