Naoki Okumura1,2,3, Taeil Son1,4,2, Yoo Min Kim4,5, Hyoung-Il Kim1,2, Ji Yeong An1,2, Sung Hoon Noh1,2, Woo Jin Hyung6,7,8. 1. Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. 2. Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea. 3. Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan. 4. Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, South Korea. 5. Department of Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea. 6. Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. wjhyung@yuhs.ac. 7. Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea. wjhyung@yuhs.ac. 8. Robot and Minimally Invasive Surgery Center, Severance Hospital, Yonsei University Health System, Seoul, South Korea. wjhyung@yuhs.ac.
Abstract
BACKGROUND: Robotic surgery for gastric cancer has been adopted to overcome technical difficulties in performing laparoscopic gastrectomy. This study aimed to investigate the feasibility and safety of robotic gastrectomy in elderly gastric cancer patients. METHODS: Patients who underwent laparoscopic or robotic gastrectomy from 2003 to 2010 in a single high-volume center were included in this study. We retrospectively compared preoperative characteristics, perioperative factors, and oncological parameters among an elderly (≥70 years old) robotic gastrectomy group (n = 49), a younger (<70 years old) robotic gastrectomy group (n = 321), and an elderly laparoscopic gastrectomy group (n = 132). RESULTS: The elderly robotic group presented with more comorbidities than the younger robotic group. Except for number of retrieved lymph nodes (36.5 vs. 41.5; P = 0.007), short-term operative outcomes including complications and pathological parameters were comparable between the two robotic groups. The elderly robotic group showed comparable disease-specific survival to the younger robotic group although overall survival was worse. Compared to their laparoscopic counterparts, the elderly robotic group showed longer mean operation time (227 vs. 174 min). Nevertheless, the incidence and severity of postoperative complications was not different between the two elderly groups. Overall and disease-specific survival were also comparable between the elderly groups. In multivariate analysis, age and surgical approach were not risk factors for overall and major complications. CONCLUSIONS: The outcomes of robotic gastrectomy in the elderly did not differ from those in younger robotic gastrectomy patients and were comparable to those in elderly patients who underwent laparoscopic gastrectomy. Thus, robotic gastrectomy could be a safe and feasible approach in elderly patients.
BACKGROUND: Robotic surgery for gastric cancer has been adopted to overcome technical difficulties in performing laparoscopic gastrectomy. This study aimed to investigate the feasibility and safety of robotic gastrectomy in elderly gastric cancerpatients. METHODS:Patients who underwent laparoscopic or robotic gastrectomy from 2003 to 2010 in a single high-volume center were included in this study. We retrospectively compared preoperative characteristics, perioperative factors, and oncological parameters among an elderly (≥70 years old) robotic gastrectomy group (n = 49), a younger (<70 years old) robotic gastrectomy group (n = 321), and an elderly laparoscopic gastrectomy group (n = 132). RESULTS: The elderly robotic group presented with more comorbidities than the younger robotic group. Except for number of retrieved lymph nodes (36.5 vs. 41.5; P = 0.007), short-term operative outcomes including complications and pathological parameters were comparable between the two robotic groups. The elderly robotic group showed comparable disease-specific survival to the younger robotic group although overall survival was worse. Compared to their laparoscopic counterparts, the elderly robotic group showed longer mean operation time (227 vs. 174 min). Nevertheless, the incidence and severity of postoperative complications was not different between the two elderly groups. Overall and disease-specific survival were also comparable between the elderly groups. In multivariate analysis, age and surgical approach were not risk factors for overall and major complications. CONCLUSIONS: The outcomes of robotic gastrectomy in the elderly did not differ from those in younger robotic gastrectomy patients and were comparable to those in elderly patients who underwent laparoscopic gastrectomy. Thus, robotic gastrectomy could be a safe and feasible approach in elderly patients.
Authors: Jacques Ferlay; Isabelle Soerjomataram; Rajesh Dikshit; Sultan Eser; Colin Mathers; Marise Rebelo; Donald Maxwell Parkin; David Forman; Freddie Bray Journal: Int J Cancer Date: 2014-10-09 Impact factor: 7.396
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: Jung Ho Kim; Jinnam Kim; Woon Ji Lee; Hye Seong; Heun Choi; Jin Young Ahn; Su Jin Jeong; Nam Su Ku; Taeil Son; Hyoung-Il Kim; Sang Hoon Han; Jun Yong Choi; Chang Oh Kim; Joon-Sup Yeom; Woo Jin Hyung; Young Goo Song; Sung Hoon Noh; June Myung Kim Journal: Medicine (Baltimore) Date: 2019-08 Impact factor: 1.817