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Comparison of Short-Term Outcomes After Robotic Versus Laparoscopic Radical Gastrectomy for Advanced Gastric Cancer in Elderly Individuals: A Propensity Score-Matching Study

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Robotic gastrectomy (RG) has been widely used to treat gastric cancer. However, whether the short-term outcomes of robotic gastrectomy are superior to those of laparoscopic gastrectomy (LG) for elderly patients with advanced gastric cancer has not been reported.

Methods

The study enrolled of 594 elderly patients with advanced gastric cancer who underwent robotic or laparoscopic radical gastrectomy. The RG cohort was matched 1:3 with the LG cohort using propensity score-matching (PSM).

Results

After PSM, 121 patients were included in the robot group and 363 patients in the laparoscopic group. Excluding the docking and undocking times, the operation time of the two groups was similar (P = 0.617). The RG group had less intraoperative blood loss than the LG group (P < 0.001). The time to ambulation and first liquid food intake was significantly shorter in the RG group than in the LG group (P < 0.05). The incidence of postoperative complications did not differ significantly between the two groups (P = 0.14). Significantly more lymph nodes were dissected in the RG group than in the LG group (P = 0.001). Postoperative adjuvant chemotherapy was started earlier in the RG group than in the LG group (P = 0.02).

Conclusions

For elderly patients with advanced gastric cancer, RG is safe and feasible. Compared with LG, RG is associated with less intraoperative blood loss; a faster postoperative recovery time, allowing a greater number of lymph nodes to be dissected; and earlier adjuvant chemotherapy.

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Acknowledgment

We are grateful to the patients and their families for their participation in this study and to the doctors and nurses at our center.

Funding

This study was supported by Fujian Provincial Medical “Building High-Level Hospitals, High-level Clinical Medical Centers and Key Clinical Specialty Projects” (no. 76; 2021), Fujian Research and Training Grants for Young and Middle-aged Leaders in Healthcare (no. 954; 2022), Fujian third batch of “Innovation Star” Talent Project (no. 22; 2022).

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Author notes

  1. Zhi-Wei Zheng, Mi Lin and Hua-Long Zheng have equally contributed to this work and are considered co-first authors.

Authors and Affiliations

  1. Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China

    Zhi-Wei Zheng MD, Mi Lin MD, Hua-Long Zheng MD, Qi-Yue Chen MD, PhD, Jian-Xian Lin MD, PhD, Zhen Xue MD, Bin-Bin Xu MD, Jin-Tao Li MD, Ling-Hua Wei MD, Hong-Hong Zheng MD, Jia Lin MD, Fu-Hai Wang MD, Li-Li Shen MD, Wen-Feng Li MD, Ling-Kang Zhang MD, Chang-Ming Huang MD & Ping Li MD, PhD

  2. Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Zhi-Wei Zheng MD, Mi Lin MD, Hua-Long Zheng MD, Qi-Yue Chen MD, PhD, Jian-Xian Lin MD, PhD, Zhen Xue MD, Bin-Bin Xu MD, Jin-Tao Li MD, Ling-Hua Wei MD, Hong-Hong Zheng MD, Jia Lin MD, Fu-Hai Wang MD, Li-Li Shen MD, Wen-Feng Li MD, Ling-Kang Zhang MD, Chang-Ming Huang MD & Ping Li MD, PhD

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Contributions

ZZW, LM, ZHL, LJX, XZ, XBB, CQY, and LP conceived the study, analyzed the data, and drafted the manuscript. LJT, ZHH, WLH, LJ, WFH, SLL, LWF, and ZLK helped collect data and helped collect data and design the study. CQY,design the study. CQY, HCM, and LP helped critically revise the manuscript. LP helped critically revise the manuscript for important intellectual content.

Corresponding author

Correspondence to Ping Li MD, PhD.

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Therea are no conflicts of interest.

Human Rights Statement

All procedures followed were by the ethical standards of the responsible committee on hu man experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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Informed consent or substitute for it was obtained from all patients for being included in the study.

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Zheng, ZW., Lin, M., Zheng, HL. et al. Comparison of Short-Term Outcomes After Robotic Versus Laparoscopic Radical Gastrectomy for Advanced Gastric Cancer in Elderly Individuals: A Propensity Score-Matching Study. Ann Surg Oncol 31, 2679–2688 (2024). https://doi.org/10.1245/s10434-023-14808-2

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