Single-incision laparoscopic versus laparoscopy-assisted subtotal gastrectomy for peptic ulcers: a retrospective comparative study

Background/Aims: The application of single-incision laparoscopic surgery (SILS) for peptic ulcer remains controversial. The aim of this study was to compare clinical outcomes and postoperative parameters of transumbilical single-incision laparoscopic subtotal gastrectomy (SILSG) versus laparoscopy-assisted subtotal gastrectomy (LASG) for benign peptic ulcer. Methods: Data from 31 patients who underwent laparoscopic subtotal gastrectomy for benign peptic ulcers between January 2008 and May 2014 at Shengjing Hospital was collected retrospectively. Among them, 13 underwent SILSG and 18 underwent LASG. Demographic, intraoperative, and postoperative data were analyzed and compared between the two groups. Results: The mean operation time was significantly longer in the SILSG group than in the LASG group (285.8 +/- 45.5 vs. 224.7 +/- 49.1 min, respectively; P=0.001). However, the postoperative hospital stay was significantly shorter (7.9 +/- 0.9 vs. 9.3 +/- 2.0 days, respectively; P=0.029), and the mean total PSAS score was significantly lower (3.9 +/- 0.9 vs. 4.9 +/- 1.1, respectively; P=0.013) in the SILSG group than in the LASG group. There were no significant differences between the two groups with respect to other variables. Conclusion: Compared to LASG, SILSG is a technically feasible procedure with better cosmesis and equivalent curability. Prospective randomized trials with long-term follow-up are needed to evaluate definitive clinical and aesthetic advantages of this technique.