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Annals of Surgical Oncology

, Volume 24, Issue 7, pp 1770–1777 | Cite as

Surgical Outcomes After Open, Laparoscopic, and Robotic Gastrectomy for Gastric Cancer

  • Seung Yoon Yang
  • Kun Ho Roh
  • You-Na Kim
  • Minah Cho
  • Seung Hyun Lim
  • Taeil Son
  • Woo Jin Hyung
  • Hyoung-Il KimEmail author
Gastrointestinal Oncology

Abstract

Background

In contrast to the significant advantages of laparoscopic versus open gastrectomy, robotic gastrectomy has shown little benefit over laparoscopic gastrectomy. This study aimed to compare multi-dimensional aspects of surgical outcomes after open, laparoscopic, and robotic gastrectomy.

Methods

Data from 915 gastric cancer patients who underwent gastrectomy by one surgeon between March 2009 and May 2015 were retrospectively reviewed. Perioperative parameters were analyzed for short-term outcomes. Surgical success was defined as the absence of conversion to open surgery, major complications, readmission, positive resection margin, or fewer than 16 retrieved lymph nodes.

Results

This study investigated 241 patients undergoing open gastrectomy, 511 patients undergoing laparoscopic gastrectomy, and 173 patients undergoing robotic gastrectomy. For each approach, the respective incidences were as follows: conversion to open surgery (not applicable, 0.4%, and 0%; p = 0.444), in-hospital major complications (5.8, 2.7, and 1.2%; p = 0.020), delayed complications requiring readmission (2.9, 2.0, and 1.2%; p = 0.453), positive resection margin (1.7, 0, and 0%; p = 0.003), and inadequate number of retrieved lymph nodes (0.4, 4.1, and 1.7%; p = 0.010). Compared with open and laparoscopic surgery, robotic gastrectomy had the highest surgical success rate (90, 90.8, and 96.0%). Learning-curve analysis of success using cumulative sum plots showed success with the robotic approach from the start. Multivariate analyses identified age, sex, and gastrectomy extent as significant independent parameters affecting surgical success. Surgical approach was not a contributing factor.

Conclusions

Open, laparoscopic, and robotic gastrectomy exhibited different incidences and causes of surgical failure. Robotic gastrectomy produced the best surgical outcomes, although the approach method itself was not an independent factor for success.

Keywords

Laparoscopy Group Laparoscopic Gastrectomy Positive Resection Margin Retrieve Lymph Node Open Gastrectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgement

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT & Future Planning (NRF-2013R1A1A1007706). The authors acknowledge the assistance of BioScience Writers, LLC (Houston, TX, USA) in copyediting of the manuscript and corrections of English language usage.

Disclosure

There are no conflicts of interest.

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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Seung Yoon Yang
    • 1
  • Kun Ho Roh
    • 1
  • You-Na Kim
    • 1
  • Minah Cho
    • 1
  • Seung Hyun Lim
    • 1
  • Taeil Son
    • 1
  • Woo Jin Hyung
    • 1
    • 2
  • Hyoung-Il Kim
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of SurgeryYonsei University College of Medicine, Yonsei University Health SystemSeoulKorea
  2. 2.Robot and Minimally Invasive Surgery CenterYonsei University Health SystemSeoulKorea
  3. 3.Open NBI Convergence Technology Research Laboratory, Severance HospitalYonsei University Health SystemSeoulKorea

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