Robotic gastrectomy for gastric cancer: surgical techniques and clinical merits
- 756 Downloads
Robotic gastrectomy in the setting of gastric cancer is reported by some investigators. However, no study has compared robotic surgery with open or laparoscopic surgery for patients with gastric cancer. This study aimed to determine the clinical benefits of robotic gastrectomy over open and laparoscopic gastrectomy for the treatment of gastric cancer.
After the introduction of the da Vinci surgical system in November 2007 at the authors’ hospital, 18 robotic gastrectomies were performed from 31 December 2007 to 30 June 2008. The prospective data from gastric cancer patients who underwent gastrectomies (16 robotic, 11 laparoscopic, and 12 open) during the same period were retrospectively analyzed.
Sex, age, comorbidity, extent of lymphadenectomy, pT stage, lymph node metastasis, and number of lymph nodes retrieved were similar among the three groups. The estimated blood loss was significantly less in the robotic gastrectomy group than in the open group (p = 0.0312), and the postoperative hospital stay in the robotic group was significantly shorter than in the open and laparoscopic gastrectomy groups (p < 0.001). Postoperative morbidity and time to first flatus were similar in the three groups. There was no open or laparoscopic conversion in the robotic group. No postoperative mortality occurred in any group.
Robotic gastrectomy for the treatment of gastric cancer is a feasible and safe procedure in the hands of experienced laparoscopic surgeons. Robotic gastrectomy offers better short-term surgical outcomes than the open and laparoscopic methods. Furthermore, this procedure may be a preferable alternative for the treatment of gastric cancer.
KeywordsComparative study Gastric cancer Robotic gastrectomy
This study was supported by research funds from Dong-A University.
- 1.National Institutes of Health Consensus Development Conference Statement (1993) Gallstones and laparoscopic cholecystectomy. J Laparoendosc Surg 3:77–90Google Scholar
- 2.Kim MC, Kim W, Kim HH, Ryu SW, Ryu SY, Song KY, Lee HJ, Cho GS, Han SU, Hyung WJ, Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group (2008) Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer: a large-scale Korean multicenter study. Ann Surg Oncol 15:2692–2700CrossRefPubMedGoogle Scholar
- 14.Pugliese R, Maggioni D, Sansonna F, Ferrari GC, Forgione A, Costanzi A, Magistro C, Pauna J, Di Lernia S, Citterio D, Brambilla C (2009) Outcomes and survival after laparoscopic gastrectomy for adenocarcinoma: analysis on 65 patients operated on by conventional or robot-assisted minimal access procedures. Eur J Surg Oncol 35:281–288PubMedGoogle Scholar
- 16.Sano T, Sasako M, Yamamoto S, Nashimoto A, Kurita A, Hiratsuka M, Tsujinaka T, Kinoshita T, Arai K, Yamamura Y, Okajima K (2004) Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended paraaortic lymphadenectomy. Japan Clinical Oncology Group study 9501. J Clin Oncol 22:2767–2773CrossRefPubMedGoogle Scholar