J M Park1, H I Kim2, S U Han3, H K Yang4, Y W Kim5, H J Lee4, J Y An2, M C Kim6, S Park7, K Y Song8, S J Oh9, S H Kong4, B J Suh9, D H Yang10, T K Ha11, W J Hyung2, K W Ryu12. 1. Department of Surgery, Chung-Ang University College of Medicine, Seoul, South Korea. 2. Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea. 3. Department of Surgery, Ajou University College of Medicine, Gyeonggido, South Korea. 4. Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea. 5. Center for Gastric Cancer, National Cancer Center, Gyeonggido, South Korea. 6. Department of Surgery, Dong-A University College of Medicine, Busan, South Korea. 7. Department of Surgery, Korea University College of Medicine, Seoul, South Korea. 8. Department of Surgery, The Catholic University of Korea, Seoul, South Korea. 9. Department of Surgery, Inje University College of Medicine, Busan, South Korea. 10. Department of Surgery, Hallym University College of Medicine, Seoul, South Korea. 11. Department of Surgery, Hanyang University College of Medicine, Seoul, South Korea. 12. Center for Gastric Cancer, National Cancer Center, Gyeonggido, South Korea. Electronic address: docryu@korea.com.
Abstract
AIMS: Robotic gastrectomy for gastric cancer has been proven to be a feasible and safe minimally invasive procedure. However, our previous multicenter prospective study indicated that robotic gastrectomy is not superior to laparoscopic gastrectomy. This study aimed to identify which subgroups of patients would benefit from robotic gastrectomy rather than from conventional laparoscopic gastrectomy. METHODS: A prospective multicenter comparative study comparing laparoscopic and robotic gastrectomy was previously conducted. We divided the patients into subgroups according to obesity, type of gastrectomy performed, and extent of lymph node dissection. Surgical outcomes were compared between the robotic and laparoscopic groups in each subgroup. RESULTS: A total of 434 patients were enrolled into the robotic (n = 223) and laparoscopic (n = 211) surgery groups. According to obesity and gastrectomy type, there was no difference in the estimated blood loss (EBL), number of retrieved lymph nodes, complication rate, open conversion rate, and the length of hospital stay between the robotic and laparoscopic groups. According to the extent of lymph node dissection, the robotic group showed a significantly lower EBL than did the laparoscopic group after D2 dissection (P = 0.021), while there was no difference in EBL in patients that did not undergo D2 dissection (P = 0.365). CONCLUSION: Patients with gastric cancer undergoing D2 lymph node dissection can benefit from less blood loss when a robotic surgery system is used.
AIMS: Robotic gastrectomy for gastric cancer has been proven to be a feasible and safe minimally invasive procedure. However, our previous multicenter prospective study indicated that robotic gastrectomy is not superior to laparoscopic gastrectomy. This study aimed to identify which subgroups of patients would benefit from robotic gastrectomy rather than from conventional laparoscopic gastrectomy. METHODS: A prospective multicenter comparative study comparing laparoscopic and robotic gastrectomy was previously conducted. We divided the patients into subgroups according to obesity, type of gastrectomy performed, and extent of lymph node dissection. Surgical outcomes were compared between the robotic and laparoscopic groups in each subgroup. RESULTS: A total of 434 patients were enrolled into the robotic (n = 223) and laparoscopic (n = 211) surgery groups. According to obesity and gastrectomy type, there was no difference in the estimated blood loss (EBL), number of retrieved lymph nodes, complication rate, open conversion rate, and the length of hospital stay between the robotic and laparoscopic groups. According to the extent of lymph node dissection, the robotic group showed a significantly lower EBL than did the laparoscopic group after D2 dissection (P = 0.021), while there was no difference in EBL in patients that did not undergo D2 dissection (P = 0.365). CONCLUSION:Patients with gastric cancer undergoing D2 lymph node dissection can benefit from less blood loss when a robotic surgery system is used.
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