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

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

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.

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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.

Author information

Authors and Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea

    Seung Yoon Yang MD, Kun Ho Roh MD, You-Na Kim MD, Minah Cho MD, Seung Hyun Lim MD, Taeil Son MD, Woo Jin Hyung MD, PhD & Hyoung-Il Kim MD

  2. Robot and Minimally Invasive Surgery Center, Yonsei University Health System, Seoul, Korea

    Woo Jin Hyung MD, PhD & Hyoung-Il Kim MD

  3. Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei University Health System, Seoul, Korea

    Hyoung-Il Kim MD

Authors
  1. Seung Yoon Yang MD
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  2. Kun Ho Roh MD
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  3. You-Na Kim MD
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  6. Taeil Son MD
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  7. Woo Jin Hyung MD, PhD
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Correspondence to Hyoung-Il Kim MD.

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Yang, S.Y., Roh, K.H., Kim, YN. et al. Surgical Outcomes After Open, Laparoscopic, and Robotic Gastrectomy for Gastric Cancer. Ann Surg Oncol 24, 1770–1777 (2017). https://doi.org/10.1245/s10434-017-5851-1

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  • DOI: https://doi.org/10.1245/s10434-017-5851-1

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