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Comparison of Surgical Outcomes Between Robotic and Laparoscopic Distal Gastrectomy for cT1 Gastric Cancer

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Abstract

Background

Increasing numbers of patients are treated by robotic distal gastrectomy (RDG); however, it remains unclear whether RDG is clinically comparable with conventional laparoscopic distal gastrectomy (LDG). This study aimed to clarify the feasibility of RDG from safety aspects.

Methods

The study included 109 cT1 gastric cancer patients who underwent RDG at Shizuoka Cancer Center from January 2012 to April 2015. Short-term outcomes were compared with 160 cT1 gastric cancer patients who underwent LDG during the same period.

Results

Patient characteristics were well matched. The RDG patients experienced longer operative times (323 min) than LDG patients (285 min; P < 0.001), although all other surgical outcomes were comparable between the groups. Drain amylase levels on POD 1 were significantly lower in the RDG group compared to LDG cases (median 452 U/L and 892 U/L; P < 0.001). The incidence of all complications was similar across the study patients, although intra-abdominal infectious complications tended to be lower in the RDG group than in the LDG group (2.8 and 8.1%; P = 0.112).

Conclusions

RDG was comparable to LDG in terms of feasibility for cT1 gastric cancer. RDG has the potential to reduce pancreas damage and thus to decrease intra-abdominal infectious complications.

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Funding

This research was partially supported by the National Cancer Center Research and Development Fund (26-A-4) and Practical Research for Innovative Cancer Control (15ck0106043h0002) from the Japan Agency for Medical Research and Development.

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Authors and Affiliations

  1. Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan

    Makoto Hikage, Masanori Tokunaga, Rie Makuuchi, Tomoyuki Irino, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura & Masanori Terashima

  2. Department of Surgery, Sendai City Hospital, Miyagi, Japan

    Makoto Hikage

  3. Gastric Surgery Division, National Cancer Center East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Chiba, Japan

    Masanori Tokunaga

Authors
  1. Makoto Hikage
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  2. Masanori Tokunaga
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  3. Rie Makuuchi
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  4. Tomoyuki Irino
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  5. Yutaka Tanizawa
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  6. Etsuro Bando
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  7. Taiichi Kawamura
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  8. Masanori Terashima
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Corresponding author

Correspondence to Masanori Tokunaga.

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Conflict of interest

Masanori Tokunaga has received honoraria from Ethicon. Etsuro Bando received honorarium from Ethicon. Masanori Terashima has received honoraria from Ethicon and Intuitive. Hikage, Makuuchi, Irino, Tanizawa and Kawamura have no conflicts of interest or financial ties to disclose.

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Hikage, M., Tokunaga, M., Makuuchi, R. et al. Comparison of Surgical Outcomes Between Robotic and Laparoscopic Distal Gastrectomy for cT1 Gastric Cancer. World J Surg 42, 1803–1810 (2018). https://doi.org/10.1007/s00268-017-4345-4

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  • DOI: https://doi.org/10.1007/s00268-017-4345-4

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