Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2020; 26(31): 4669-4679
Published online Aug 21, 2020. doi: 10.3748/wjg.v26.i31.4669
Initial experience of single-incision plus one port left-side approach totally laparoscopic distal gastrectomy with uncut Roux-en-Y reconstruction
Wei Zhou, Chang-Zheng Dong, Yi-Feng Zang, Ying Xue, Xing-Guo Zhou, Yu Wang, Yin-Lu Ding
Wei Zhou, Chang-Zheng Dong, Yi-Feng Zang, Ying Xue, Xing-Guo Zhou, Yu Wang, Yin-Lu Ding, Department of Gastrointestinal Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
Author contributions: Zhou W, Dong C Z and Zang Y F designed the research and analyzed the data; Zhou W drafted the manuscript; Xue Y, Zhou X G and Wang Y collected the data; Zhou W and Ding Y L revised the paper; all authors read and approved the final version.
Supported by Key R& D Programs in Shandong China, No. 2019GSF10822; and Jinan Science & Technology Bureau, No. 201704125.
Institutional review board statement: The study was reviewed and approved by The Second Hospital, Cheeloo College of Medicine, Shandong University Institutional Review Board.
Conflict-of-interest statement: We declare that there are no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yin-Lu Ding, MD, Chief Doctor, Department of Gastrointestinal Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, No. 247 Beiyuan Street, Jinan 250012, Shandong Province, China. dingyinlu@126.com
Received: April 19, 2020
Peer-review started: April 19, 2020
First decision: June 8, 2020
Revised: June 21, 2020
Accepted: July 23, 2020
Article in press: July 23, 2020
Published online: August 21, 2020
Processing time: 123 Days and 14 Hours
ARTICLE HIGHLIGHTS
Research background

Single-incision laparoscopic surgery plus one port (SILS+1), in which fewer ports and shorter length of incisions are needed, has become increasingly popular in the past few years. However, the safety of SILS+1 left-side approach (SILS+1/L) totally laparoscopic distal gastrectomy (TLDG) with uncut Roux-en-Y reconstruction is not clear.

Research motivation

An analysis of an uncut R-Y reconstruction method after SILS+1 has not been carried out. To the best of our knowledge, there are no previous reports on the use of SILS+1/L TLDG with uncut R-Y reconstruction.

Research objectives

This study aimed to evaluate the safety and feasibility of SILS+1/L with the uncut R-Y digestive reconstruction procedure in TLDG. This report is to present our initial experience in performing SILS+1/L TLDG with uncut R-Y reconstruction as well as the short-term postoperative outcomes and endoscopic findings.

Research methods

The statistics of 21 patients who had undergone SILS+1/L TLDG with uncut R-Y anastomosis reconstruction to treat distal gastric cancer were collected. Data exploration was used as appropriate. All statistical analyses were performed using SPSS for Windows.

Research results

The mean operating time was 146 min (ranged 130-180 min), and the estimated mean blood loss was 54 mL (ranged 20-110 mL). The mean length of the proximal and distal margins was 4.2 and 6.4 cm, respectively. The number of retrieved lymph nodes ranged from 30-47 with a mean of 42. One patient experienced mild postoperative pancreatic fistula ileus, and one patient experienced surgical site infection. Other complications did not occur in our study.

Research conclusions

We found that SILS+1/L TLDG with uncut Roux-en-Y reconstruction is safe and effective and should be popularized.

Research perspectives

From this study, we can found that SILS+1/L TLDG with uncut R-Y reconstruction can be used not only for colon surgery but also for gastric surgery. In the future, the direction of the research is that an effective perioperative management program specific for gastric cancer is developed. The best method is to conduct a large-scale clinical trial to verify it.