Progress in single-incision laparoscopic surgery for gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LI Guoxin

Department of General Surgery, Southern Hospital, Southern Medical University, Guangzhou 510515, P. R. China;

Corresponding?author：

LI Guoxin, Email: gzliguoxin@163.com

Keywords：

gastric cancer; single-incision; laparoscope; minimally invasive surgery

DOI：

10.7507/1007-9424.202310003

Video：

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With the upgrading of minimally invasive surgical concepts and laparoscopic equipment for gastric cancer, single-incision laparoscopic surgery (SILS) had emerged as a new focus of research in gastric cancer surgery. SILS offered advantages such as reduced damage, superior cosmetic outcomes, decreased postoperative pain, and faster recovery as compared with traditional laparoscopic gastrectomy. However, its level of difficulty limited its further promotion and application. Although numerous studies supported the safety and feasibility of SILS, more high-level evidence-based medical research was required to endorse its widespread use. The author reviewed the development history, current status, and prospects of SILS laparoscopic gastric cancer surgery.

Citation： LI Guoxin. Progress in single-incision laparoscopic surgery for gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(10): 1169-1172. doi: 10.7507/1007-9424.202310003 Copy

1.	Yu J, Huang C, Sun Y, et al. Effect of laparoscopic vs open distal gastrectomy on 3-year disease-free survival in patients with locally advanced gastric cancer: the CLASS-01 randomized clinical trial. JAMA, 2019, 321(20): 1983-1992.
2.	Hu Y, Huang C, Sun Y, et al. Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer: a randomized controlled trial. J Clin Oncol, 2016, 34(12): 1350-1357.
3.	Liu F, Huang C, Xu Z, et al. Morbidity and mortality of laparoscopic vs open total gastrectomy for clinical stage i gastric cancer: the CLASS02 Multicenter randomized clinical trial. JAMA Oncol, 2020, 6(10): 1590-1597.
4.	Son SY, Hur H, Hyung WJ, et al. Laparoscopic vs open distal gastrectomy for locally advanced gastric cancer: 5-year outcomes of the KLASS-02 randomized clinical trial. JAMA Surg, 2022, 157(10): 879-886.
5.	Chen XH, Hu YF, Luo J, et al. The safety of esophagojejunostomy via a transorally inserted-anvil method vs extracorporeal anastomosis using a circular stapler during total gastrectomy for Siewert type 2 adenocarcinoma of the esophagogastric junction. Gastroenterol Rep (Oxf), 2019, 8(3): 242-251.
6.	Chen Y, Yang Z, Zhao M, et al. Impact of preoperative therapy on surgical outcomes of laparoscopic total gastrectomy for gastric/gastroesophageal junction cancer. Chin J Cancer Res, 2023, 35(4): 354-364.
7.	Omori T, Oyama T, Akamatsu H, et al. Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancer. Surg Endosc, 2011, 25(7): 2400-2404.
8.	Kim SM, Ha MH, Seo JE, et al. Comparison of reduced port totally laparoscopic distal gastrectomy (Duet TLDG) and conventional laparoscopic-assisted distal gastrectomy. Ann Surg Oncol, 2015, 22(8): 2567-2572.
9.	Kawamura H, Tanioka T, Shibuya K, et al. Comparison of the invasiveness between reduced-port laparoscopy-assisted distal gastrectomy and conventional laparoscopy-assisted distal gastrectomy. Int Surg, 2013, 98(3): 247-253.
10.	Kunisaki C, Miyamoto H, Sato S, et al. Surgical outcomes of reduced-port laparoscopic gastrectomy versus conventional laparoscopic gastrectomy for gastric cancer: a propensity-matched retrospective cohort study. Ann Surg Oncol, 2018, 25(12): 3604-3612.
11.	Karthik S, Augustine AJ, Shibumon MM, et al. Analysis of laparoscopic port site complications: a descriptive study. J Minim Access Surg, 2013, 9(2): 59-64.
12.	Park DJ, Lee JH, Ahn SH, et al. Single-port laparoscopic distal gastrectomy with D1+β lymph node dissection for gastric cancers: report of 2 cases. Surg Laparosc Endosc Percutan Tech, 2012, 22(4): e214-e216.
13.	中國醫師協會微無創專業委員會外科單孔學組. 單孔加一腹腔鏡胃癌手術操作專家共識(2020版). 腹腔鏡外科雜志, 2021, 26(1): 7-12.
14.	Kong J, Wu SD, Su Y. Translumenal single-incision laparoscopy radical gastrectomy with D2 lymph node dissection for early gastric cancer--primary experience with less invasive surgery in China. J Laparoendosc Adv Surg Tech A, 2013, 23(2): 141-145.
15.	Suh YS, Park JH, Kim TH, et al. Unaided stapling technique for pure single-incision distal gastrectomy in early gastric cancer: Unaided Delta-shaped anastomosis and uncut Roux-en-Y anastomosis. J Gastric Cancer, 2015, 15(2): 105-112.
16.	Kim SM, Lee SH, Ha MH, et al. Techniques of the single-port totally laparoscopic distal gastrectomy. Ann Surg Oncol, 2015 Dec: 22 Suppl 3: S341. doi: 10.1245/s10434-015-4839-y.
17.	Ertem M, Ozveri E, Gok H, et al. Single incision laparoscopic total gastrectomy and D2 lymph node dissection for gastric cancer using a four-access single port: the first experience. Case Rep Surg, 2013, 2013: 504549.
18.	Ahn SH, Park DJ, Son SY, et al. Single-incision laparoscopic total gastrectomy with D1+β lymph node dissection for proximal early gastric cancer. Gastric Cancer, 2014, 17(2): 392-396.
19.	Lin T, Mou TY, Hu YF, et al. Reduced port laparoscopic distal gastrectomy with D2 lymphadenectomy. Ann Surg Oncol, 2018, 25(1): 246.
20.	林填, 余江, 胡彥鋒, 等. 兩孔法腹腔鏡遠端胃癌根治術的初步經驗. 中華胃腸外科雜志, 2019, 22(1): 35-42.
21.	林填, 陳新華, 胡彥鋒, 等. 單孔加一孔腹腔鏡與傳統五孔腹腔鏡遠端胃癌D2根治術安全性對比的傾向性得分匹配分析. 腹部外科, 2022, 35(6): 402-407.
22.	林填, 胡彥鋒, 余江等. 單孔+1腹腔鏡全胃切除、D2淋巴結清掃術. 中華普外科手術學雜志(電子版), 2021, 15(2): 143.
23.	Chen XH, Lin T, Huang H, et al. Application value of Overlap guiding tube (OGT) in assisting Overlap esophagojejunostomy during laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumors. Gastric Cancer, 2022, 25(4): 827-836.
24.	Chen XH, Huang HL, Li GX, et al. ASO author reflections: OGT-assisted method made the Overlap esophagojejunostomy in laparoscopic total gastrectomy easier. Ann Surg Oncol, 2023, 30(5): 2739-2740.
25.	Chen XH, Lin T, Zhao ML, et al. ASO visual abstract: safety and efficacy of OGT-assisted Overlap oesophagojejunostomy versus traditional Overlap method in laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumours. Ann Surg Oncol, 2023, 30(5): 2741-2742.
26.	Chen X, Lin T, Zhao M, et al. Safety and efficacy of OGT-assisted Overlap oesophagojejunostomy versus the traditional Overlap method in laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumours. Ann Surg Oncol, 2023, 30(5): 2729-2738.
27.	陳新華, 胡彥鋒, 林填, 等. Overlap引導管在腹腔鏡全胃切除Overlap食管空腸吻合術中的應用價值. 中華消化外科雜志, 2022, 21(1): 99-105.
28.	陳新華, 李國新, 張馳, 等. 胃癌圍手術期并發癥. 中華胃腸外科雜志, 2023, 26(2): 160-166.
29.	Omori T, Fujiwara Y, Moon J, et al. 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(Suppl 5): 817-824.
30.	Lee B, Youn SI, Lee K, et al. 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. Ann Surg Treat Res, 2021, 100(2): 67-75.
31.	楊波. 經臍單孔腹腔鏡與傳統五孔腹腔鏡胃癌D2根治術治療早期胃癌患者的效果比較. 中國民康醫學, 2020, 32(22): 115-117.
32.	王家興, 黃隆鍇, 何慶良. 單孔腹腔鏡胃竇癌根治術對患者圍手術期免疫功能的影響. 中華實驗外科雜志, 2019, 36(7): 1295-1298.

1. Yu J, Huang C, Sun Y, et al. Effect of laparoscopic vs open distal gastrectomy on 3-year disease-free survival in patients with locally advanced gastric cancer: the CLASS-01 randomized clinical trial. JAMA, 2019, 321(20): 1983-1992.
2. Hu Y, Huang C, Sun Y, et al. Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer: a randomized controlled trial. J Clin Oncol, 2016, 34(12): 1350-1357.
3. Liu F, Huang C, Xu Z, et al. Morbidity and mortality of laparoscopic vs open total gastrectomy for clinical stage i gastric cancer: the CLASS02 Multicenter randomized clinical trial. JAMA Oncol, 2020, 6(10): 1590-1597.
4. Son SY, Hur H, Hyung WJ, et al. Laparoscopic vs open distal gastrectomy for locally advanced gastric cancer: 5-year outcomes of the KLASS-02 randomized clinical trial. JAMA Surg, 2022, 157(10): 879-886.
5. Chen XH, Hu YF, Luo J, et al. The safety of esophagojejunostomy via a transorally inserted-anvil method vs extracorporeal anastomosis using a circular stapler during total gastrectomy for Siewert type 2 adenocarcinoma of the esophagogastric junction. Gastroenterol Rep (Oxf), 2019, 8(3): 242-251.
6. Chen Y, Yang Z, Zhao M, et al. Impact of preoperative therapy on surgical outcomes of laparoscopic total gastrectomy for gastric/gastroesophageal junction cancer. Chin J Cancer Res, 2023, 35(4): 354-364.
7. Omori T, Oyama T, Akamatsu H, et al. Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancer. Surg Endosc, 2011, 25(7): 2400-2404.
8. Kim SM, Ha MH, Seo JE, et al. Comparison of reduced port totally laparoscopic distal gastrectomy (Duet TLDG) and conventional laparoscopic-assisted distal gastrectomy. Ann Surg Oncol, 2015, 22(8): 2567-2572.
9. Kawamura H, Tanioka T, Shibuya K, et al. Comparison of the invasiveness between reduced-port laparoscopy-assisted distal gastrectomy and conventional laparoscopy-assisted distal gastrectomy. Int Surg, 2013, 98(3): 247-253.
10. Kunisaki C, Miyamoto H, Sato S, et al. Surgical outcomes of reduced-port laparoscopic gastrectomy versus conventional laparoscopic gastrectomy for gastric cancer: a propensity-matched retrospective cohort study. Ann Surg Oncol, 2018, 25(12): 3604-3612.
11. Karthik S, Augustine AJ, Shibumon MM, et al. Analysis of laparoscopic port site complications: a descriptive study. J Minim Access Surg, 2013, 9(2): 59-64.
12. Park DJ, Lee JH, Ahn SH, et al. Single-port laparoscopic distal gastrectomy with D1+β lymph node dissection for gastric cancers: report of 2 cases. Surg Laparosc Endosc Percutan Tech, 2012, 22(4): e214-e216.
13. 中國醫師協會微無創專業委員會外科單孔學組. 單孔加一腹腔鏡胃癌手術操作專家共識(2020版). 腹腔鏡外科雜志, 2021, 26(1): 7-12.
14. Kong J, Wu SD, Su Y. Translumenal single-incision laparoscopy radical gastrectomy with D2 lymph node dissection for early gastric cancer--primary experience with less invasive surgery in China. J Laparoendosc Adv Surg Tech A, 2013, 23(2): 141-145.
15. Suh YS, Park JH, Kim TH, et al. Unaided stapling technique for pure single-incision distal gastrectomy in early gastric cancer: Unaided Delta-shaped anastomosis and uncut Roux-en-Y anastomosis. J Gastric Cancer, 2015, 15(2): 105-112.
16. Kim SM, Lee SH, Ha MH, et al. Techniques of the single-port totally laparoscopic distal gastrectomy. Ann Surg Oncol, 2015 Dec: 22 Suppl 3: S341. doi: 10.1245/s10434-015-4839-y.
17. Ertem M, Ozveri E, Gok H, et al. Single incision laparoscopic total gastrectomy and D2 lymph node dissection for gastric cancer using a four-access single port: the first experience. Case Rep Surg, 2013, 2013: 504549.
18. Ahn SH, Park DJ, Son SY, et al. Single-incision laparoscopic total gastrectomy with D1+β lymph node dissection for proximal early gastric cancer. Gastric Cancer, 2014, 17(2): 392-396.
19. Lin T, Mou TY, Hu YF, et al. Reduced port laparoscopic distal gastrectomy with D2 lymphadenectomy. Ann Surg Oncol, 2018, 25(1): 246.
20. 林填, 余江, 胡彥鋒, 等. 兩孔法腹腔鏡遠端胃癌根治術的初步經驗. 中華胃腸外科雜志, 2019, 22(1): 35-42.
21. 林填, 陳新華, 胡彥鋒, 等. 單孔加一孔腹腔鏡與傳統五孔腹腔鏡遠端胃癌D2根治術安全性對比的傾向性得分匹配分析. 腹部外科, 2022, 35(6): 402-407.
22. 林填, 胡彥鋒, 余江等. 單孔+1腹腔鏡全胃切除、D2淋巴結清掃術. 中華普外科手術學雜志(電子版), 2021, 15(2): 143.
23. Chen XH, Lin T, Huang H, et al. Application value of Overlap guiding tube (OGT) in assisting Overlap esophagojejunostomy during laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumors. Gastric Cancer, 2022, 25(4): 827-836.
24. Chen XH, Huang HL, Li GX, et al. ASO author reflections: OGT-assisted method made the Overlap esophagojejunostomy in laparoscopic total gastrectomy easier. Ann Surg Oncol, 2023, 30(5): 2739-2740.
25. Chen XH, Lin T, Zhao ML, et al. ASO visual abstract: safety and efficacy of OGT-assisted Overlap oesophagojejunostomy versus traditional Overlap method in laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumours. Ann Surg Oncol, 2023, 30(5): 2741-2742.
26. Chen X, Lin T, Zhao M, et al. Safety and efficacy of OGT-assisted Overlap oesophagojejunostomy versus the traditional Overlap method in laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumours. Ann Surg Oncol, 2023, 30(5): 2729-2738.
27. 陳新華, 胡彥鋒, 林填, 等. Overlap引導管在腹腔鏡全胃切除Overlap食管空腸吻合術中的應用價值. 中華消化外科雜志, 2022, 21(1): 99-105.
28. 陳新華, 李國新, 張馳, 等. 胃癌圍手術期并發癥. 中華胃腸外科雜志, 2023, 26(2): 160-166.
29. Omori T, Fujiwara Y, Moon J, et al. 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(Suppl 5): 817-824.
30. Lee B, Youn SI, Lee K, et al. 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. Ann Surg Treat Res, 2021, 100(2): 67-75.
31. 楊波. 經臍單孔腹腔鏡與傳統五孔腹腔鏡胃癌D2根治術治療早期胃癌患者的效果比較. 中國民康醫學, 2020, 32(22): 115-117.
32. 王家興, 黃隆鍇, 何慶良. 單孔腹腔鏡胃竇癌根治術對患者圍手術期免疫功能的影響. 中華實驗外科雜志, 2019, 36(7): 1295-1298.

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Progress in single-incision laparoscopic surgery for gastric cancer

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