Abstract
Background
Robot-assisted gastrectomy (RAG) is a new minimally invasive surgical technique for gastric cancer. This study was designed to compare RAG with laparoscopy-assisted gastrectomy (LAG) in short-term surgical outcomes.
Methods
Between October 2011 and August 2014, 423 patients underwent robotic or laparoscopic gastrectomy for gastric cancer: 93 RAG and 330 LAG. We performed a comparative analysis between RAG group and LAG group for clinicopathological characteristics and short-term surgical outcomes.
Results
RAG was associated with a longer operative time (P < 0.001), lower blood loss (P = 0.001), and more harvested lymph nodes (P = 0.047). Only three patients in LAG group had positive margins, and R0 resection rate for RAG and LAG was similar (P = 0.823). The RAG group had postoperative complications of 9.8 %, comparable with those of the LAG group (P = 0.927). Proximal margin, distal margin, hospital stay, days of first flatus, and days of eating liquid diet for RAG and LAG were similar. In the subgroup of serosa-negative patients, RAG had a longer operation time (P = 0.003), less intraoperative blood loss (P = 0.005), and more harvested lymph nodes (P = 0.04). However, in the subgroup of serosa-positive patients, RAG had a longer operation time (P = 0.001), but no less intraoperative blood loss (P = 0.139) and no more harvested lymph nodes (P = 0.139). Similarly, in the subgroup of total gastrectomy patients, RAG had a longer operation time (P = 0.018), but no less intraoperative blood loss (P = 0.173).
Conclusions
The comparative study demonstrates that RAG is as acceptable as LAG in terms of surgical and oncologic outcomes. With lower estimated blood loss, acceptable complications, and radical resection, RAG is a promising approach for the treatment of gastric cancer. However, the indication of patients for RAG is critical.
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Acknowledgments
This study was supported by a Grant from the Special Scientific Research Foundation of Health Sector from the National Health and Family Planning Commission of China (No. 201302016), PLA Medical Technology key project of scientific research in the 12th Research Projects in 12th 5-Year-Plan (No. BWS12J049), and Project supported by the National High Technology Research and Development Program of China (No. 2012AA02A504).
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Weisong Shen, Hongqing Xi, Bo Wei, Jianxin Cui, Shibo Bian, Kecheng Zhang, Ning Wang, Xiaohu Huang, Lin Chen have no conflict of interest or financial ties to disclose.
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Weisong Shen, Hongqing Xi and Bo Wei have contributed equally to this work.
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Shen, W., Xi, H., Wei, B. et al. Robotic versus laparoscopic gastrectomy for gastric cancer: comparison of short-term surgical outcomes. Surg Endosc 30, 574–580 (2016). https://doi.org/10.1007/s00464-015-4241-7
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DOI: https://doi.org/10.1007/s00464-015-4241-7