ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1627001
This article is part of the Research TopicReal-World Clinical and Translational Research in Gastrointestinal CancersView all 13 articles
Safety and Efficacy of Left-sided Three-port Laparoscopic Gastric Cancer Surgery: A Prospective Observational Study
Provisionally accepted
- 1Shanxi Medical University Affiliated Yuncheng City Central Hospital, Department of Gastrointestinal Surgery, Yuncheng , Shanxi,China, xian, China
- 2Department of General Surgery,Tianji Hospital, changzhi, China
- 3The First Affiliated Hospital of the Air Force Medical University 986 hospital,, xian, China
- 4The First Affiliated Hospital of the Air Force Medical University, xian, China
- 5Xijing Hospital, Air Force Medical University, Xi’an, China
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Background: While reduced-port laparoscopic gastrectomy( RPLG) has emerged as a minimally invasive alternative, its standardization and long-term efficacy remain underexplored. This study evaluates the comparative outcomes of three-port (TPLDG) versus five-port laparoscopic distal gastrectomy (FPLDG).Methods: This prospective multicenter study enrolled 355 gastric cancer patients meeting selection criteria. Surgical procedures adhered to D2 lymphadenectomy guidelines, with TPLDG utilizing a left-sided approach without auxiliary ports. Primary endpoints included inflammatory markers, recovery parameters, and 3-year survival outcomes.Results:The operative outcomes showed comparable results between groups, with similar operative times [140(125,160)vs.135(120,150)minutes, p=0.068)] and total lymph node retrieved [(22(19,27) vs. 22(18,27) nodes, p=0.696)]. Notably, the TPLDG group demonstrated significant recovery advantages, including earlier flatus [(2(2,3) vs.3(2,3) days, p<0.001)], shorter hospital stays [4(3,5)vs.5.2(4.2,6.3)days, p<0.001)], and reduced inflammatory responses as evidenced by lower postoperative CRP [(48.2±21.4)vs. (68.5±25.6) mg/L, p<0.01) ] and IL-6 levels [(82.3±31.2) vs. (115.4±38.5)pg/mL,p<0.01)]. Importantly, oncological outcomes remained equivalent between groups, with comparable 3-year disease-free survival (85.4% vs 85.8%, p=0.85) and overall survival rates (89.4% vs 89.2%, p=0.70), which were consistently maintained across stage-stratified analyses.Conclusion: TPLDG achieves comparable oncological outcomes to conventional FPLDG while offering significant advantages in postoperative recovery and inflammatory response reduction. The left-sided three-port technique represents a viable standardized approach for RPLG, particularly suited for D2 lymphadenectomy in Asian populations.
Keywords: Gastrectomy, Laparoscopy, Reduced port surgery, stomach neoplasm, Survival
Received: 12 May 2025; Accepted: 14 Aug 2025.
Copyright: © 2025 Fang, Li, Gao, Guo, Ji, Song and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiangpeng Wei, Xijing Hospital, Air Force Medical University, Xi’an, China
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