Review on Perioperative and Oncological Outcomes of Robotic Gastrectomy for Cancer.

Giuseppe Giuliani,Andrea Coratti,Roberto Benigni,Lorenzo De Franco,Lucia Salvischiani,Francesco Guerra

doi:10.3390/jpm11070638

Giuseppe Giuliani, Andrea Coratti + Show 4 more

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https://doi.org/10.3390/jpm11070638

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Abstract

Background. Minimally invasive gastrectomy is currently considered a valid option to treat gastric cancer and is gaining increasing acceptance. Recent reports have suggested that the application of robots may confer some advantages over conventional laparoscopy, but the role of robotic surgery in clinical practice is still uncertain. We aimed to critically review the relevant evidence comparing robotic to standard laparoscopic surgery in performing radical gastrectomy. Methods. The Pubmed/Medline electronic databases were searched through February 2021. Paper conference and the English language was the only restriction applied to our search strategy. Results. According to the existing data, robotic gastrectomy seems to provide some benefits in terms of blood loss, rate of conversion, procedure-specific postoperative morbidity, and length of hospital stay. Robotic gastrectomy is also associated with a longer duration of surgery and a higher economic burden as compared to its laparoscopic counterpart. No significant differences have been disclosed in terms of long-term survivals, while the number of lymph nodes retrieved with robotic gastrectomy is generally higher than that of laparoscopy. Conclusions. The current literature suggests that robotic radical gastrectomy appears as competent as the conventional laparoscopic procedure and may provide some clinical advantages. However, due to the relative paucity of high-level evidence, it is not possible to draw definitive conclusions.

Highlights

The PubMed/MEDLINE electronic databases were queried with the following search strings: “robot-assisted surgery” and “laparoscopic” and “gastric cancer” or “gastric neoplasm” and “gastrectomy” or “gastric resection”
Several studies, including several meta-analyses, indicate that the duration of surgery for robotic gastrectomy (RG) is invariably higher than for Laparoscopic Gastrectomy (LG), for both total and distal gastrectomy [4,5,12,16,18,19,20]. Such difference seems to be attenuated by the progress of specific experience with the technique
The studies included in our updates on robotic gastrectomy for cancer demonstrate superior surgical outcomes of RG as compared to LG, especially in terms of perioperative blood losses, rates of conversion, procedure-related postoperative morbidity, and length of hospital stay

Summary

Introduction

The employment of laparoscopic techniques in gastric surgery has diffused and evolved rapidly over the last two decades [1,2,3]. Is almost universally accepted as a valid option for the treatment of gastric cancer (GC) as it optimizes postoperative recovery without compromising the adequacy of resection and long-term oncological outcomes [1,2,3,4,5,6]. Invasive gastrectomy is currently considered a valid option to treat gastric cancer and is gaining increasing acceptance. Recent reports have suggested that the application of robots may confer some advantages over conventional laparoscopy, but the role of robotic surgery in clinical practice is still uncertain. We aimed to critically review the relevant evidence comparing robotic to standard laparoscopic surgery in performing radical gastrectomy

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Conclusion