Abstract
BackgroundMinimally invasive surgery, including laparoscopic and robotic gastrectomy, has become more popular in the treatment of gastric cancer. However, few studies have compared the learning curves between laparoscopic and robotic gastrectomy for gastric cancer.MethodsData were prospectively collected between July 2008 and Aug 2014. A total of 145 patients underwent minimally invasive gastrectomy for gastric cancer by a single surgeon, including 73 laparoscopic and 72 robotic gastrectomies. The clinicopathologic characteristics, operative outcomes and learning curves were compared between the two groups.ResultsCompared with the laparoscopic group, the robotic group was associated with less blood loss and longer operative time. After the surgeon learning curves were overcome for each technique, the operative outcomes became similar between the two groups except longer operative time in the robotic group. After accumulating more cases of robotic gastrectomy, the operative time in the laparoscopic group decreased dramatically.ConclusionsAfter overcoming the learning curves, the operative outcomes became similar between laparoscopic and robotic gastrectomy. The experience of robotic gastrectomy could affect the learning process of laparoscopic gastrectomy.
Highlights
Invasive gastrectomy is becoming a widely accepted procedure, especially in Asian countries
Our early experience with robotic gastrectomy was consistent with these meta-analysis; we found less operative blood loss and a shorter postoperative hospital stay compared with laparoscopic and open gastrectomy [12]
Patients in the robotic group were associated with more extracorporeal anastomosis with Roux-en-Y reconstruction, a higher percentage of D2 lymphadenectomy, and more medical costs compared to patients in the laparoscopic group
Summary
Invasive gastrectomy is becoming a widely accepted procedure, especially in Asian countries. Laparoscopic gastrectomy offers improved early postoperative outcomes and improved long-term oncologic outcomes that are comparable to those that are achieved with open gastrectomy [1,2,3]. For surgeons with laparoscopic surgery experience, fewer cases are necessary to learn robotic surgery. Several meta-analysis studies have compared the short-term results among robotic, laparoscopic and open gastrectomy [6,7,8,9,10,11]. Our early experience with robotic gastrectomy was consistent with these meta-analysis; we found less operative blood loss and a shorter postoperative hospital stay compared with laparoscopic and open gastrectomy [12]. Invasive surgery, including laparoscopic and robotic gastrectomy, has become more popular in the treatment of gastric cancer. Few studies have compared the learning curves between laparoscopic and robotic gastrectomy for gastric cancer
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