Young-Woo Kim1, Daniel Reim1, Ji Yeon Park1, Bang Wool Eom1, Myeong-Cherl Kook1, Keun Won Ryu1, Hong Man Yoon2. 1. Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Korea. 2. Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Korea. red10000@ncc.re.kr.
Abstract
PURPOSE: Despite theoretical advantages, no clear benefit was proven for initial application of robotic surgery for gastric cancer so far. The aim of this analysis was to examine the role of robotic surgery regarding nodal dissection technically demanding areas compared to conventional laparoscopic surgery. METHODS: This analysis included 87 patients who underwent robot-assisted distal gastrectomy (RADG) and 288 patients who underwent laparoscopy-assisted distal gastrectomy (LADG) at the National Cancer Center, Korea, between February 2009 and September 2011. Clinicopathologic data, surgery-related data, postoperative morbidity, and pathologic data for each nodal station were analyzed. RESULTS: Time to flatulence was 3.5 ± 0.8 days for RADG and 3.8 ± 0.8 days for LADG (P = 0.01). Postoperative hospital stay was 6.7 ± 1.0 days in RADG and 7.4 ± 2.4 days in LADG (P < 0.001).The number of dissected lymph nodes was 37.1 ± 12.9 in the RADG group and 34.1 ± 12.1 in the LADG group (P = 0.044). In patients undergoing D2 gastrectomy, the number of dissected lymph nodes in the N2 area was 16.3 ± 7.7 for RADG and 13.2 ± 5.3 for LADG (P = 0.001). The number of dissected lymph nodes around the splenic artery area was 2.9 ± 2.9 in RADG and 2.2 ± 2.0 in LADG (P = 0.04). Regarding postoperative complications, there was no statistically significant difference [five patients (5.7%) in RADG and 26 patients (9%) in LADG) (P = 0.330)]. CONCLUSION: RADG could provide an advantage over LADG in the dissection of the N2 area lymph nodes, especially around the splenic artery area.
PURPOSE: Despite theoretical advantages, no clear benefit was proven for initial application of robotic surgery for gastric cancer so far. The aim of this analysis was to examine the role of robotic surgery regarding nodal dissection technically demanding areas compared to conventional laparoscopic surgery. METHODS: This analysis included 87 patients who underwent robot-assisted distal gastrectomy (RADG) and 288 patients who underwent laparoscopy-assisted distal gastrectomy (LADG) at the National Cancer Center, Korea, between February 2009 and September 2011. Clinicopathologic data, surgery-related data, postoperative morbidity, and pathologic data for each nodal station were analyzed. RESULTS: Time to flatulence was 3.5 ± 0.8 days for RADG and 3.8 ± 0.8 days for LADG (P = 0.01). Postoperative hospital stay was 6.7 ± 1.0 days in RADG and 7.4 ± 2.4 days in LADG (P < 0.001).The number of dissected lymph nodes was 37.1 ± 12.9 in the RADG group and 34.1 ± 12.1 in the LADG group (P = 0.044). In patients undergoing D2 gastrectomy, the number of dissected lymph nodes in the N2 area was 16.3 ± 7.7 for RADG and 13.2 ± 5.3 for LADG (P = 0.001). The number of dissected lymph nodes around the splenic artery area was 2.9 ± 2.9 in RADG and 2.2 ± 2.0 in LADG (P = 0.04). Regarding postoperative complications, there was no statistically significant difference [five patients (5.7%) in RADG and 26 patients (9%) in LADG) (P = 0.330)]. CONCLUSION: RADG could provide an advantage over LADG in the dissection of the N2 area lymph nodes, especially around the splenic artery area.
Authors: B W Eom; H M Yoon; K W Ryu; J H Lee; S J Cho; J Y Lee; C G Kim; I J Choi; J S Lee; M C Kook; J Y Rhee; S R Park; Y W Kim Journal: Eur J Surg Oncol Date: 2011-09-25 Impact factor: 4.424
Authors: Andrea Coratti; Mario Annecchiarico; Michele Di Marino; Edoardo Gentile; Francesco Coratti; Pier Cristoforo Giulianotti Journal: World J Surg Date: 2013-12 Impact factor: 3.352
Authors: Ji Yeon Park; Young-Woo Kim; Keun Won Ryu; Bang Wool Eom; Hong Man Yoon; Daniel Reim Journal: J Gastric Cancer Date: 2013-12-31 Impact factor: 3.720
Authors: Stefano Caruso; Alberto Patriti; Franco Roviello; Lorenzo De Franco; Franco Franceschini; Andrea Coratti; Graziano Ceccarelli Journal: World J Gastroenterol Date: 2016-07-07 Impact factor: 5.742