Makoto Hikage1,2, Masanori Tokunaga3,4, Rie Makuuchi1, Tomoyuki Irino1, Yutaka Tanizawa1, Etsuro Bando1, Taiichi Kawamura1, Masanori Terashima1. 1. Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan. 2. Department of Surgery, Sendai City Hospital, Miyagi, Japan. 3. Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan. mtokunag@east.ncc.go.jp. 4. Gastric Surgery Division, National Cancer Center East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Chiba, Japan. mtokunag@east.ncc.go.jp.
Abstract
BACKGROUND: Increasing numbers of patients are treated by robotic distal gastrectomy (RDG); however, it remains unclear whether RDG is clinically comparable with conventional laparoscopic distal gastrectomy (LDG). This study aimed to clarify the feasibility of RDG from safety aspects. METHODS: The study included 109 cT1 gastric cancer patients who underwent RDG at Shizuoka Cancer Center from January 2012 to April 2015. Short-term outcomes were compared with 160 cT1 gastric cancer patients who underwent LDG during the same period. RESULTS: Patient characteristics were well matched. The RDG patients experienced longer operative times (323 min) than LDG patients (285 min; P < 0.001), although all other surgical outcomes were comparable between the groups. Drain amylase levels on POD 1 were significantly lower in the RDG group compared to LDG cases (median 452 U/L and 892 U/L; P < 0.001). The incidence of all complications was similar across the study patients, although intra-abdominal infectious complications tended to be lower in the RDG group than in the LDG group (2.8 and 8.1%; P = 0.112). CONCLUSIONS: RDG was comparable to LDG in terms of feasibility for cT1 gastric cancer. RDG has the potential to reduce pancreas damage and thus to decrease intra-abdominal infectious complications.
BACKGROUND: Increasing numbers of patients are treated by robotic distal gastrectomy (RDG); however, it remains unclear whether RDG is clinically comparable with conventional laparoscopic distal gastrectomy (LDG). This study aimed to clarify the feasibility of RDG from safety aspects. METHODS: The study included 109 cT1gastric cancerpatients who underwent RDG at Shizuoka Cancer Center from January 2012 to April 2015. Short-term outcomes were compared with 160 cT1gastric cancerpatients who underwent LDG during the same period. RESULTS:Patient characteristics were well matched. The RDG patients experienced longer operative times (323 min) than LDG patients (285 min; P < 0.001), although all other surgical outcomes were comparable between the groups. Drain amylase levels on POD 1 were significantly lower in the RDG group compared to LDG cases (median 452 U/L and 892 U/L; P < 0.001). The incidence of all complications was similar across the study patients, although intra-abdominal infectious complications tended to be lower in the RDG group than in the LDG group (2.8 and 8.1%; P = 0.112). CONCLUSIONS: RDG was comparable to LDG in terms of feasibility for cT1gastric cancer. RDG has the potential to reduce pancreas damage and thus to decrease intra-abdominal infectious complications.