Comparison of Reduced Port Totally Laparoscopic Distal Gastrectomy (Duet TLDG) and Conventional Laparoscopic-Assisted Distal Gastrectomy

Background: Laparoscopic-assisted distal gastrectomy (LADG) is a treatment method for patients with early gastric cancer; however, single or reduced port LADG has been rarely reported. This study aimed to compare surgical outcomes of patients with gastric cancer undergoing reduced port totally laparoscopic distal gastrectomy (duet TLDG) to those of patients undergoing conventional LADG. Methods: This retrospective study included 202 patients with early gastric cancer who underwent duet TLDG (102 patients) or conventional LADG (100 patients) at Samsung Medical Center between October 2013 and April 2014. Results: Operating time was shorter for duet TLDG than for conventional LADG (mean ± SD 121.1 ± 19.3 min vs. 153.0 ± 38.1 min, P < 0.001). Blood loss during surgery was similar between duet TLDG and conventional LADG groups (91.4 ± 68.4 mL vs. 85.4 ± 59.8 mL, P = 0.506). Complication rates in the duet TLDG and conventional LADG groups were similar (15.7 % vs. 10.0 %, P = 0.294). The quality of lymph node dissection, including the median number of nodes dissected (median [range] duet TLDG vs. conventional LADG, 36 [17–76] vs. 34 [15–64], P = 0.570) and number of dissected nodes in each lymph node station, did not differ between groups. The median postoperative hospital stay was similar (7 [7–23] days vs. 7 [6–9], P = 0.423). Pain scores were 3.6, 3.2, and 2.8, and 3.7, 3.1, and 2.6, at postoperative days 1, 3, and 5, respectively, in the duet TLDG and conventional LADG groups (P = 0.408, 0.250, and 0.130). Conclusions: Reduced port duet TLDG for early gastric cancer is feasible in terms of patient safety and quality of lymph node dissection.