Short-Term Clinical Outcomes After Laparoscopic and Robotic Gastrectomy for Gastric Cancer: a Propensity Score Matching Analysis

Abstract

Background

The different advantages of laparoscopic gastrectomy (LG) and robotic gastrectomy (RG), two new minimally invasive surgical techniques for gastric cancer, remain controversial.

Purpose

To compare the short-term clinical outcomes of LG and RG.

Methods

A retrospective, single-center comparative study of 1044 patients (LG = 750, RG = 294) was conducted. Patients undergoing LG and RG were matched (2:1 ratio) according to sex, age, BMI, extent of gastric resection, and pathologic stage. The primary outcomes were morbidity and mortality and perioperative recovery parameters; major types of complications were also analyzed.

Results

After matching, 798 patients (LG = 532, RG = 266) were included. Both the LG and RG groups showed similar overall complication rates (LG = 12.8% vs RG = 12.4%) and operative mortality (LG = 0.4% vs RG = 0.4%). Compared to those who underwent LG, patients undergoing RG had significantly longer operative times (236.92 ± 57.28 vs 217.77 ± 65.00 min, p < 0.001), higher total costs (US$16,241.42 vs US$12,497, p < 0.001), less operative blood loss (77.07 ± 64.37 vs 103.68 ± 86.92 ml, p < 0.001), higher numbers of retrieved lymph nodes (32.0 vs 29.9, p < 0.001), and higher rates of retrieving more than 16 lymph nodes (94.0 vs 85.5%; p < 0.001). No significant differences between groups were noted in terms of the rate of reoperation, time until a soft diet was consumed, or length of hospital stay. The major complication and readmission rates were similar in both groups.

Conclusion

RG and LG produced similar short-term clinical outcomes, indicating that RG is a safe and beneficial surgical procedure.

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Fig. 1

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Funding

This work was supported by National Natural Science Foundation of China (grant 81270449 and 81572314), Natural Science Foundation of Shandong Provincial, China (grant ZR2012HM046), Key Research and Development Program of Shandong Province, China (grant 2016GGB01022), Qingdao Minsheng Science and Technology Foundation, Shandong, China (grant 14-2-3-5-nsh) and the Qingdao Science and Technology Plan Project (grant 13-1-4-220-jch).

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Ying Kong and Yanbing Zhou were involved in the concept, design, data acquisition, analysis and interpretation, and production of figures and tables and wrote the first draft and revised it critically in light of comments from other authors. Shougen Cao, Liankai Wang, Xiaodong Liu and Zequn Li were involved in the conception, interpretation, manuscript revision, and discussion. Cunlong Lu, Houxin Zhu and Shuai Shen were involved in data acquisition and literature review. All the authors approved the final version submitted. The authors would like to thank American Journal Experts for the help with the editing of this manuscript.

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Correspondence to Yanbing Zhou.

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Short-term outcomes after laparoscopic and robotic gastrectomy for gastric cancer

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Kong, Y., Cao, S., Liu, X. et al. Short-Term Clinical Outcomes After Laparoscopic and Robotic Gastrectomy for Gastric Cancer: a Propensity Score Matching Analysis. J Gastrointest Surg 24, 531–539 (2020). https://doi.org/10.1007/s11605-019-04158-4

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Keywords

  • Short-term clinical outcomes
  • Laparoscopic gastrectomy
  • Robotic gastrectomy
  • Gastric cancer