单切口腹腔镜胃切除术治疗超重和肥胖胃癌患者的技术挑战和安全问题仍不清楚。本研究旨在评价单切口腹腔镜远端胃切除术（SIDG）与多孔腹腔镜远端胃切除术（MLDG）相比在超重和肥胖胃癌患者中的安全性和可行性。本研究回顾性分析超重和肥胖患者（体重指数 ≥ 25） kg/m2）和病理阶段T1原发性胃腺癌用SIDG或MLDG治疗。 SIDG组和MLDG组以年龄、性别、身高、体重、美国麻醉医师协会分类、手术年份、病理N分期、吻合方式为协变量，按1：2比例进行倾向评分匹配。1：2匹配后，该研究包括接受 SIDG (n = 179) 和 MLDG (n = 358) 的患者。 SIDG组和MLDG组的淋巴结回收数量没有显着差异（52.8±19.3 vs. 53.9±21.0，P=0.56）。 SIDG 组的手术时间显着缩短（170.8±60.0 分钟 vs 186.1±52.6 分钟，P=0.004）。两组术后住院时间相当（SIDG：5.9 ± 3.4天 vs. MLDG：6.3± 5.1天，P = 0.23），术后并发症发生率也相当（SIDG：13.4% vs. MLDG：12.8%， P = 0.89）。对于超重和肥胖胃癌患者，SIDG 被证明与 MLDG 一样安全可行，与 MLDG 相比，其早期术后并发症发生率相当，且不影响手术时间。© 2024。作者。

The technical challenges and safety concerns of single-incision laparoscopic gastrectomy for overweight and obese gastric cancer patients remain unclear. This study aimed to evaluate the safety and feasibility of single-incision laparoscopic distal gastrectomy (SIDG) compared to multiport laparoscopic distal gastrectomy (MLDG) in overweight and obese gastric cancer patients.This study retrospectively analyzed overweight and obese patients (body mass index ≥ 25 kg/m2) and pathologic stage T1 primary gastric adenocarcinoma treated with either SIDG or MLDG. The SIDG and MLDG groups were propensity score matched at a 1:2 ratio using age, sex, height, body weight, American Society of Anesthesiologists classification, year of surgery, pathologic N stage, and anastomosis method as covariates.After 1:2 matching, the study included patients who underwent SIDG (n = 179) and MLDG (n = 358). No significant difference in the number of retrieved lymph nodes was found between the SIDG and MLDG groups (52.8 ± 19.3 vs. 53.9 ± 21.0, P = 0.56). Operation times were significantly shorter in the SIDG group (170.8 ± 60.0 min vs. 186.1 ± 52.6 min, P = 0.004). The postoperative hospital length of stay was comparable between the 2 groups (SIDG: 5.9 ± 3.4 days vs. MLDG: 6.3 ± 5.1 days, P = 0.23), as was postoperative complication rate (SIDG: 13.4% vs. MLDG: 12.8%, P = 0.89).SIDG was shown to be as safe and feasible as MLDG for overweight and obese gastric cancer patients, with comparable early postoperative complication rates without compromising operation time compared to MLDG.© 2024. The Author(s).