Short-term outcomes of single-incision compared to multi-port laparoscopic gastrectomy for gastric cancer: A meta-analysis of randomized controlled trials

Objective

Single-incision laparoscopic surgery has emerged as a safe and less invasive approach to conventional multi-port laparoscopy. The present meta-analysis aimed to assess the collective outcomes of single-incision laparoscopic gastrectomy (SILG) compared to multi-port laparoscopic gastrectomy (MLG) for gastric cancer.

Methods

A PRISMA-compliant systematic review of randomized controlled trials (RCTs) that compared SILG and MLG for gastric cancer in PubMed and Scopus through January 2023 was conducted. The main outcomes of the review were complications, postoperative pain, conversion to open surgery, hospital stay, and recovery.

Results

Three RCTs including 301 patients (61.8% male) were included. A total of 151 patients underwent SILG, and 150 underwent MLG. SILG was associated with a shorter operative time (WMD = −16.39, 95% CI: −27.38 to −5.40, p = 0.003; I² = 0%) and lower pain scores at postoperative day 3 (WMD = −1.18, 95% CI: −2.27 to −0.091, p = 0.033; I² = 99%) than MLG. There were no statistically significant differences between the two groups in estimated blood loss (WMD = –16.95, 95% CI: −35.84 to 1.95, p = 0.078; I² = 82%), complications (OR = 0.71, 95% CI: 0.36 to 1.42, p = 0.337; I² = 0%), conversion to open surgery (OR = 0.33, 95% CI: 0.01 to 8.38, p = 0.504), hospital stay (WMD = 0.72, 95% CI: −0.92 to 2.36, p = 0.056; I² = 84%), time to first flatus (WMD = 0.06, 95% CI: −0.14 to 0.26, p = 0.566; I² = 0%), time to first defecation (WMD = −0.14, 95% CI: −0.46 to 0.18, p = 0.392; I² = 0%), or time to first oral intake (WMD = 0.37, 95% CI: −0.75 to 1.49, p = 0.520; I² = 94%).

Conclusions

SILG is associated with shorter operative times and less early postoperative pain than MLG. The odds of complications, blood loss, hospital stay, and gastrointestinal recovery were similar between the two procedures.