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Widjaja J, Yang J, Dong W, Wang R, Yang D, Song Z, Gu Y. Single-Port One Anastomosis Sleeve Gastrectomy with Transit Bipartition: Initial Experience and Technique. Obes Surg 2024:10.1007/s11695-024-07295-1. [PMID: 38773010 DOI: 10.1007/s11695-024-07295-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Sleeve gastrectomy with transit bipartition (SG-TB) procedure has been gaining traction recently. While being a relatively novel procedure, it shows potentials to improve the standalone SG outcomes, such as diabetes remission and reflux. This article aims to show insights on performing SG-TB in one anastomosis fashion (SG-OATB) and single-port approach. METHODS Three patients who underwent laparoscopic single-port SG-OATB at our hospital were included. The parameters included in this study comprised of age, gender, height, weight, body mass index (BMI), type 2 diabetes mellitus (T2DM) assessment, gastroesophageal reflux disease (GERD) assessment, length of the small bowel, the duration of the procedure, and 30-day readmission rate. RESULTS The mean preoperative assessments for the three patients were as follows: two females vs. one male; age 38.7 ± 5.5 years old; weight 105.7 ± 5.4 kg; height 1.64 ± 0.11 m; BMI 39.3 ± 4.7 kg/m2; fasting blood glucose 6.7 ± 1.2 mmol/L; glycosylated hemoglobin level 7.1 ± 1.3%; GERD-Questionnaire score 6.3 ± 1.5; two patients with esophagitis grade A and B following endoscopy. The total duration of the procedure was 170.0 ± 26.5 min; there was no need for conversion to multiple-port in all patients. The 30-day readmission rate for all patients was 0%. CONCLUSION In our small cases of patients, single-port SG-OATB is feasible and safe. We found the closure of the anastomosis defect to be most technically demanding. To understand better the outcome of single-port SG-OATB, studies with larger sample and longer follow-up will be needed in the future.
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Affiliation(s)
- Jason Widjaja
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Jianjun Yang
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China.
| | - Wenpei Dong
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Rui Wang
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Dongchao Yang
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Zhicheng Song
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Yan Gu
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
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Chen J, Kang Y, Lin S, He S, He Y, Xu X, Xu H, You G, Xu D. Single-port plus one in pediatric robotic-assisted Lich-Gregoir ureteral reimplantation for vesicoureteral reflux, a comparative analysis with short-term outcomes. BMC Urol 2024; 24:81. [PMID: 38589861 PMCID: PMC11000388 DOI: 10.1186/s12894-024-01467-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE To observe the safety and short-term outcomes of a new way of laparoscopic trocar placement in pediatric robotic-assisted Lich-Gregoir ureteral reimplantation for vesicoureteral reflux. METHODS The retrospective study included 32 patients under 14 years diagnosed with primary vesicoureteral reflux (VUR). All these patients underwent robotic-assisted Lich-Gregoir ureteral reimplantation in our department from December 2020 to August 2022. These patients were divided into the following groups according to the different ways of trocar placement: 13 patients in group single-port plus one (SR) and 19 patients in group multiple-port (MR). Patients' characteristics as well as their perioperative and follow-up data were collected and evaluated. RESULTS There was no significant difference in the data regarding patients' characteristics and preoperative data. These data included the grade of vesicoureteral reflux according to the voiding cystourethrogram (VCUG), and the differential degree of renal function (DRF) at the following time points: preoperative, postoperative, and comparison of preoperative and postoperative. There was no difference between the two groups. During surgery, the time of artificial pneumoperitoneum establishment, ureteral reimplantation time, and total operative time in the SR group were longer than those in the MR group. Yet only the time of artificial pneumoperitoneum establishment shows a statistical difference (P < 0.0001). Also, the peri-operative data, including the volume of blood loss, fasting time, hospitalization, and length of time that a ureteral catheter remained in place, and the number of postoperative complications demonstrate no difference. In addition, the SFU grade and VCUG grade at the following time point also show no difference between the two groups. CONCLUSION The study demonstrates that SR in robotic-assisted Lich-Gregoir ureteral reimplantation has reached the same surgical effects as MR. In addition, the single-port plus one trocar placement receives a higher cosmetic satisfaction score from parents and did not increase the surgical time and complexity.
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Affiliation(s)
- Jianglong Chen
- Department of Pediatric Surgery, Pediatric Medical Center, Fujian Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China, 350001
- Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China
| | - Yingquan Kang
- Department of Pediatric Surgery, Pediatric Medical Center, Fujian Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China, 350001
- Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China
| | - Shan Lin
- Department of Pediatric Surgery, Pediatric Medical Center, Fujian Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China, 350001
- Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China
| | - Shaohua He
- Department of Pediatric Surgery, Pediatric Medical Center, Fujian Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China, 350001
- Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China
| | - Yufeng He
- Department of Pediatric Surgery, Pediatric Medical Center, Fujian Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China, 350001
- Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China
| | - Xinru Xu
- Department of Pediatric Surgery, Pediatric Medical Center, Fujian Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China, 350001
- Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China
| | - Huihuang Xu
- Department of Pediatric Surgery, Pediatric Medical Center, Fujian Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China, 350001
- Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China
| | - Guangxu You
- Department of Pediatric Surgery, Pediatric Medical Center, Fujian Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China, 350001
- Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China
| | - Di Xu
- Department of Pediatric Surgery, Pediatric Medical Center, Fujian Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China, 350001.
- Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, China.
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Yang J, Widjaja J, Wang R, Dong W, Yang D, Song H, Song Z, Gu Y. Routine gastric suspension technique in single-port sleeve gastrectomy procedure. Surg Endosc 2023; 37:9651-9657. [PMID: 37891372 DOI: 10.1007/s00464-023-10502-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Due to limited technical demand, single-port sleeve gastrectomy (SPSG) is a feasible laparoscopic technique for sleeve gastrectomy (SG). Nonetheless, difficulties exist when performing the single-port technique, and in this study, we aim to describe a slight maneuver that can improve the SPSG procedure. METHODS Patients who underwent laparoscopic SG between January 2022 and May 2023 at our hospital were included. The patients were classified into two groups: (1) SPSG and (2) multiple-port SG (MPSG). The parameters for this analysis were the patients' age, gender, weight, body mass index (BMI), conversion rate, drainage placement, 30-day readmission rate, and postoperative complications. Postoperative one-month and three-month percentages of total weight loss (%TWL) were calculated and compared. RESULTS 171 patients were included in this study: (1) the SPSG group (n = 96) and (2) the MPSG group (n = 75). No statistically significant difference was observed within the preoperative (age, gender, height, weight, and BMI) and the perioperative parameters between SPSG and MPSG (operation time, drainage placement, 30-day readmission) (p > 0.05). Per Clavien-Dindo's grading, two patients in the SPSG group suffered grade 1 complications; for the MPSG group, one patient sustained grade 2 and another suffered grade 3b complication. No statistical significance was observed on the %TWL between the two groups (p > 0.05). CONCLUSION Our study found that performing SPSG in specific patient is feasible and non-inferior when compared to the MPSG. Further studies will be needed to elucidate better the efficacy and safety of performing SPSG.
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Affiliation(s)
- Jianjun Yang
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Jason Widjaja
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Rui Wang
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Wenpei Dong
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Dongchao Yang
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Heng Song
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Zhicheng Song
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China
| | - Yan Gu
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, 200040, People's Republic of China.
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Shahmiri SS, Parmar C, Yang W, Lainas P, Pouwels S, DavarpanahJazi AH, Chiappetta S, Seki Y, Omar I, Vilallonga R, Kassir R, Abbas SI, Bashir A, Singhal R, Kow L, Kermansaravi M. Bariatric and metabolic surgery in patients with low body mass index: an online survey of 543 bariatric and metabolic surgeons. BMC Surg 2023; 23:272. [PMID: 37689633 PMCID: PMC10492360 DOI: 10.1186/s12893-023-02175-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/29/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Metabolic and bariatric surgery (MBS) in patients with low body mass index patients is a topic of debate. This study aimed to address all aspects of controversies in these patients by using a worldwide survey. METHODS An online 35-item questionnaire survey based on existing controversies surrounding MBS in class 1 obesity was created by 17 bariatric surgeons from 10 different countries. Responses were collected and analysed by authors. RESULTS A total of 543 bariatric surgeons from 65 countries participated in this survey. 52.29% of participants agreed with the statement that MBS should be offered to class-1 obese patients without any obesity related comorbidities. Most of the respondents (68.43%) believed that MBS surgery should not be offered to patients under the age of 18 with class I obesity. 81.01% of respondents agreed with the statement that surgical interventions should be considered after failure of non-surgical treatments. CONCLUSION This survey demonstrated worldwide variations in metabolic/bariatric surgery in patients with class 1 obesity. Precise analysis of these results is useful for identifying different aspects for future research and consensus building.
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Affiliation(s)
- Shahab Shahabi Shahmiri
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Centre of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran
- Iran National Centre of Excellence for Minimally Invasive Surgery Education, Iran University of Medical Sciences, Tehran, Iran
| | - Chetan Parmar
- Consultant Surgeon and Head of Department, Whittington Hospital, London, UK
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Panagiotis Lainas
- Department of Surgery, Metropolitan Hospital, HEAL Academy, Athens, Greece
- Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, Paris-Saclay University, Clamart, France
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Amir Hossein DavarpanahJazi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Centre of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran
- Iran National Centre of Excellence for Minimally Invasive Surgery Education, Iran University of Medical Sciences, Tehran, Iran
| | - Sonja Chiappetta
- Obesity and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy
| | - Yosuke Seki
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Islam Omar
- Wirral University Teaching Hospital, Birkenhead, UK
| | - Ramon Vilallonga
- Obesity and Metabolic Surgery Unit, Vall Hebron Campus Hospital, Barcelona, Spain
| | - Radwan Kassir
- Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France
| | - Syed Imran Abbas
- Director Obesity & Metabolic Surgery Clinic, Iranian Hospital Dubai, UAE. CEO & Founder of GLR International, Dubai, UAE
| | | | - Rishi Singhal
- Consultant Bariatric & Upper GI Surgeon, Birmingham Heartlands Hospital, University Hospital Birmingham, UK. Honorary Senior Lecturer, University of Birmingham, Medical Director, Healthier Weight, Birmingham, UK
| | - Lilian Kow
- Flinders University South Australia, Adelaide, Australia
| | - Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
- Centre of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran.
- Iran National Centre of Excellence for Minimally Invasive Surgery Education, Iran University of Medical Sciences, Tehran, Iran.
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Symmetric three-port laparoscopic Roux-en-Y gastric bypass: a novel technique that is safe, effective, and feasible. Surg Today 2023; 53:702-708. [PMID: 36737497 DOI: 10.1007/s00595-022-02629-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/21/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE Single-incision laparoscopic surgery (SILS) has been validated as a safe approach for bariatric surgery. However, as the utilization of SILS in bariatric surgery is still limited by its disadvantages, this study analyzes the outcomes of symmetric three-port laparoscopic Roux-en-Y gastric bypass (STLGB). METHODS The medical records of patients who underwent STLGB between January 2018 and February 2021 were analyzed retrospectively using an institutional database. The patients were divided into four groups according to their baseline body mass index (BMI). The primary endpoints were operative time, length of stay, complication rate, and weight loss 12 months after surgery. RESULTS We analyzed the records of 101 patients who underwent STLGB. There was a slight predominance of women (n = 61; 60.4%). The mean operative time was 97.16 ± 38.79 min and the length of stay in the hospital after surgery was 2.79 ± 1.4 days. One patient (0.99%) suffered a gastrojejunal anastomosis leak within 30 days of surgery. There were no significant differences in LOS, complication rate, or cosmetic score among the four groups. The mean BMI reduction was 8.67 kg/m2 and the % total weight loss (%TWL) was 24.37%. Weight loss measured 12 months after surgery was significantly different among the four groups. CONCLUSIONS STLGB is safe, effective, and feasible for all kinds of patients. It is reproducible with standardization of the procedure.
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Safety and effectiveness of reduced-port laparoscopic sleeve gastrectomy in Asian morbidly obese patients. Sci Rep 2021; 11:23511. [PMID: 34873253 PMCID: PMC8648717 DOI: 10.1038/s41598-021-02999-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/24/2021] [Indexed: 12/04/2022] Open
Abstract
Laparoscopic sleeve gastrectomy is the most frequently performed surgical intervention in patients with morbid obesity. Single-port sleeve gastrectomy (SPSG) and reduced-port sleeve gastrectomy (RPSG) are increasingly reported in the literature. This study compared the short-term outcomes of SPSG, RPSG, and conventional laparoscopic sleeve gastrectomy (CLSG). This is a single-center retrospective study of 238 morbidly obese patients, of whom 148 (62.2%) patients completed follow-up one year after surgery. Propensity score matching was performed on factors influencing the choice of approach, and fifty patients from the SPSG + RPSG and CLSG groups were successfully matched. The groups were comparable in postoperative weight loss, morbidity, pain, and resolution of obesity-related comorbidities. The percentage of excess weight loss after one year was 90.0% in the SPSG + RPSG group and 75.2% in the CLSG group (P < 0.001). Complication rates showed no significant difference. The CLSG group was superior in dyslipidemia remission (17 [37.0%] vs. 28 [63.6%], P = 0.018) in the total cohort; however, this difference disappeared after matching. Our results suggest that single-port and reduced-port approaches could be alternative choices for selected patients. As our study was limited by its retrospective nature and potential selection bias, further studies are necessary to set standardized guidelines for SPSG.
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Lainas P, Derienne J, Zervaki S, Del Basso C, Malerba V, Devaquet N, Tranchart H, Dagher I. Left Hypochondrium or Transumbilical Single-Incision Laparoscopic Sleeve Gastrectomy for the Treatment of Severe Obesity: Surgical Technique and Results of a Tertiary Referral Bariatric Center. Obes Surg 2021; 31:5063-5070. [PMID: 34480332 DOI: 10.1007/s11695-021-05563-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/15/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Technical aspects of single-incision laparoscopic sleeve gastrectomy (SILSG) vary depending on surgeon's experience and availability of surgical equipment. We have performed more than 3000 SILSGs using standardized technique with left hypochondrium or transumbilical access. The aim of this study is to describe the SILSG technique in a stepwise manner providing technical tips and pitfalls for a left hypochondrium or transumbilical approach and report results of SILSG experience in a tertiary referral bariatric center. METHODS A detailed description of left hypochondrium and transumbilical SILSG is provided. Data from all consecutive patients who underwent SILSG between August 2010 and August 2017 were prospectively collected and retrospectively analyzed and reported. RESULTS One thousand eight hundred patients underwent SILSG, from which 384 (21.3%) using a transumbilical approach. Mean age was 42.3 years, median BMI 45.3 kg/m2, and median operative time 88 min. An additional port was required in 89 patients (4.9%). Postoperative mortality and morbidity rates were 0.05% and 7.5%, respectively. Relaparoscopy and/or endoscopic treatment were required for intra-abdominal bleeding in 27 patients (1.5%) and staple-line leakage in 35 patients (1.9%). Mean excess weight losses were 71.1%, 73.7%, and 70.4% at 1, 2, and 4 years after SILSG, respectively. Two years after SILSG, sustained statistical significant remission of major obesity-related comorbidities was noted. Incisional hernia occurred in 39 patients (2.1%). CONCLUSIONS The use of specific instruments allows standardization of left hypochondrium SILSG, which can be routinely performed for the treatment of severe obesity. Transumbilical approach for SILSG should be reserved for well-selected patients and experienced bariatric surgeons.
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Affiliation(s)
- Panagiotis Lainas
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140, Clamart, France. .,Paris-Saclay University, F-91405, Orsay, France.
| | - Joseph Derienne
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140, Clamart, France
| | - Styliani Zervaki
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140, Clamart, France.,Paris-Saclay University, F-91405, Orsay, France
| | - Celeste Del Basso
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140, Clamart, France.,Paris-Saclay University, F-91405, Orsay, France
| | - Valentina Malerba
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140, Clamart, France.,Paris-Saclay University, F-91405, Orsay, France
| | - Niaz Devaquet
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140, Clamart, France.,Paris-Saclay University, F-91405, Orsay, France
| | - Hadrien Tranchart
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140, Clamart, France.,Paris-Saclay University, F-91405, Orsay, France
| | - Ibrahim Dagher
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140, Clamart, France.,Paris-Saclay University, F-91405, Orsay, France
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Alarcón I, Yang T, Balla A, Morales-Conde S. Single/reduced port surgery vs. conventional laparoscopic gastrectomy: systematic review and meta-analysis. MINIM INVASIV THER 2021; 31:515-524. [PMID: 33600291 DOI: 10.1080/13645706.2021.1884571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The aim is to compare single port surgery (SPS)/reduced port surgery (RPS) versus conventional laparoscopy (CL) for gastrectomy for gastric cancer in terms of intra- and postoperative outcomes. MATERIAL AND METHODS After a search in Pubmed and Embase, six articles were included. Pooled analysis was used to evaluate the statistically significance for each variable. RESULTS Two hundred and thirty-three and 230 patients underwent SPS/RPS and CL, respectively. One hundred and eighty-eight patients and 45 patients underwent subtotal and total gastrectomy, respectively, using the SPS/RPS approach. One hundred and eighty-five patients and 45 patients underwent subtotal and total gastrectomy, respectively, by CL. In 85 patients, an extra trocar was systematically placed at the end of surgery. Statistically significant differences were not observed about preoperative staging. The pooled analysis regarding operative time, blood loss, postoperative complications, number of harvested lymph nodes and postoperative hospital stay showed that the only statistically significant difference between the two approaches is the shorter hospital stay in case of SPS/RPS. CONCLUSIONS SPS/RPS total or subtotal gastrectomy shows a lower postoperative hospital stay, with comparable operative time, blood loss, early postoperative complication rate and number of harvested lymph nodes in comparison to CL, provided extensive experience in minimally invasive gastrectomy is present. Abbreviations: AGC: advanced gastric cancer; BMI: body mass index; CI: confidence interval; CL: conventional laparoscopy; LESS: laparoendoscopic single site; MD: mean difference; NOS: Newcastle-Ottawa Scale; OR: odds ratio; PRISMA: Preferred Reporting Items for Systematic Review and Meta-Analysis; ROBIN-I: Risk Of Bias In Non-randomised Studies - of Interventions; RPS: reduced port surgery; RR: risk ratio; SILS: single incision laparoscopic surgery; SPS: single port surgery; WMD: weighted mean differences.
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Affiliation(s)
- Isaias Alarcón
- Department of General and Digestive Surgery, Unit of Innovation in Minimally Invasive Surgery, University Hospital "Virgen del Rocio", University of Seville, Seville, Spain
| | - Tao Yang
- Department of General and Digestive Surgery, Unit of Innovation in Minimally Invasive Surgery, University Hospital "Virgen del Rocio", University of Seville, Seville, Spain
| | - Andrea Balla
- Department of General and Digestive Surgery, Unit of Innovation in Minimally Invasive Surgery, University Hospital "Virgen del Rocio", University of Seville, Seville, Spain.,Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Rome, Italy
| | - Salvador Morales-Conde
- Department of General and Digestive Surgery, Unit of Innovation in Minimally Invasive Surgery, University Hospital "Virgen del Rocio", University of Seville, Seville, Spain.,Unit of General and Digestive Surgery, Hospital QuironSalud Sagrado Corazón, Seville, Spain
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