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Comparisons of surgical outcomes between robotic and laparoscopic total gastrectomy in patients with clinical stage I/IIA gastric cancer

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Abstract

Background

The robotic approach is especially promising for challenging surgeries, such as total gastrectomy. However, it remains unclear whether robotic total gastrectomy (RTG) is superior to conventional laparoscopic total gastrectomy (LTG). The present study aimed to clarify the impact of RTG on short- and long-term outcomes for patients with clinical stage I/IIA gastric cancer.

Methods

This study included 98 patients with clinical stage I/IIA gastric cancer who underwent minimally invasive total gastrectomy from October 2013 to December 2020 at the Shizuoka Cancer Center. The short- and long-term outcomes of RTG were compared with those of LTG.

Results

This study included 36 RTG and 58 LTG patients. RTG was associated with a significantly longer operative time than LTG (p = 0.023). All complications tended to be lower in the RTG group than in the LTG group (2.8% and 15.5%, respectively; p = 0.083). There were no patients with anastomotic leakage in the RTG group. The multivariate analysis identified LTG as the only independent risk factor for postoperative complications (odds ratio, 6.620; 95% confidence interval, 1.132–126.4; p = 0.034). The survival of the RTG and LTG groups was equivalent.

Conclusions

RTG reduced the risk of complications compared to LTG. Patients treated using the two approaches showed equivalent survival.

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Funding

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Correspondence to Masanori Terashima.

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Disclosures

Drs. Makoto Hikage, Keiichi Fujiya, Satoshi Kamiya, Yutaka Tanizawa, and Etsuro Bando have no conflicts of interest or financial ties to disclose. Dr. Masanori Terashima received personal fees from Taiho, Chugai, Ono, Bristol-Myers Squibb, Yakult, Takeda, Eli Lilly, Pfizer, and Daiichi Sankyo, outside the submitted work.

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Hikage, M., Fujiya, K., Kamiya, S. et al. Comparisons of surgical outcomes between robotic and laparoscopic total gastrectomy in patients with clinical stage I/IIA gastric cancer. Surg Endosc 36, 5257–5266 (2022). https://doi.org/10.1007/s00464-021-08903-2

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  • DOI: https://doi.org/10.1007/s00464-021-08903-2

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