Abstract
Reports in the field of robotic surgery for gastric cancer are increasing. However, studies only on patients with advanced gastric cancer (AGC) are lacking. This retrospective study was to compare the short-term outcomes of robotic-assisted distal gastrectomy (RADG) and laparoscopic-assisted distal gastrectomy (LADG) with D2 lymphadenectomy for AGC. From December 2014 to November 2019, 683 consecutive patients with AGC underwent mini-invasive assisted distal gastrectomy. Propensity-score matching (PSM) analysis was conducted to reduce patient selection bias. Short-term outcomes were compared between the two groups. The clinical features were well matched in the PSM cohort. Compared with the LADG group, the RADG group was associated with less operative blood loss, a lower rate of postoperative blood transfusion, less volume of abdominal drainage, less time to remove abdominal drainage tube, retrieved more lymph node, and lower rates of surgical complications and pancreatic fistula (P <0.05). However, the time to recovery bowel function, the length of postoperative stay, the rates of other subgroups of complications and unplanned readmission were similar between the two groups (P > 0.05). This study suggests that RADG is a safe and feasible technique with better short-term outcomes than LADG for AGC.
Highlights
Reports in the field of robotic surgery for gastric cancer are increasing
For the subgroup analysis based on operative time, the setup time and the laparotomy operation time were longer in the robotic-assisted distal gastrectomy (RADG) group than in the laparoscopic-assisted distal gastrectomy (LADG) group (P < 0.000), whereas the minimally invasive operation time was not significantly different between the two groups (106 ± 11 [77–136] min vs. 104 ± 8 [78–126] min, P = 0.276)
The RADG group was associated with less blood loss during the operation than that of the LADG group (150 ± 151 (50–1000) vs. 166 ± 139 (50–1300) mL, P = 0.000), and the rates of postoperative blood transfusion were reduced in the RADG group (2.1% vs. 5.6%, P = 0.030)
Summary
Studies only on patients with advanced gastric cancer (AGC) are lacking This retrospective study was to compare the short-term outcomes of robotic-assisted distal gastrectomy (RADG) and laparoscopic-assisted distal gastrectomy (LADG) with D2 lymphadenectomy for AGC. Since Hashizume et al first reported the use of robotic surgery for gastric cancer in 2002, a number of studies have shown the safety and advantages of robotic gastrectomy12–14 Most of these studies have analyzed patients who were at a relatively early stage of disease. To evaluate the safety and advantages of RADG for AGC, we designed this retrospective cohort study with a large sample size to compare the short-term outcomes and postoperative complications of RADG and LADG with those of D2 lymph node dissection for AGC in a high-capacity center in China
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