Background: We evaluated the feasibility of a three-port totally laparoscopic distal gastrectomy (TLDG) as a reduced port laparoscopic surgery for the treatment of early gastric cancer (EGC).
Materials and methods: In total, 110 patients who underwent three-port TLDG (n = 25) and four-port TLDG (n = 85) were enrolled. A propensity score matching analysis was used to compensate for the differences between the groups in age, gender, body mass index, Eastern Cooperative Oncology Group classification, and comorbidity. After the matching, operative details, pathological features, and short-term postoperative outcomes were compared between groups.
Results: By propensity score matching, 25 matched pairs were created, and no characteristic difference was observed between the groups. Operating time was significantly shorter in the three-port TLDG group than in the four-port TLDG group (139.4 ± 39.4 minutes versus 184.8 ± 42.1 minutes, respectively; P < .001). Duration until discharge was significantly shorter in the three-port TLDG group than in the four-port TLDG group (8.2 ± 5.6 days versus 10.2 ± 6.6 days, respectively; P < .046). Regarding pathological features, including TNM stage, no significant difference was observed between the groups.
Conclusions: The three-port TLDG is a practical method as a reduced port surgery and has better short-term outcomes than the four-port TLDG for the treatment of EGC.