Assessing the safety and efficacy of full robotic gastrectomy with intracorporeal robot-sewn anastomosis for gastric cancer: A randomized clinical trial

Wang, Gang; Jiang, Zhiwei; Zhao, Jian; Liu, Jiang; Zhang, Shu; Zhao, Kun; Feng, Xiaobo; Li, Jieshou

doi:10.1002/jso.24146

Cited by 59 publications

(54 citation statements)

References 47 publications

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“…The full text of the remaining 23 articles were reviewed; of these, 1 was excluded because it was a redundant and lower level series, 11 contained non relevant topics, 5 because it was impossible to retrieve or calculate data of interest. Finally, a total of 6 articles[21-26] (South Korea 2, China 2, Italy 1, Romania 1) were considered eligible for inclusion in the meta-analysis (Figure 1). …”

Section: Resultsmentioning

confidence: 99%

Robot-assisted laparoscopic vs open gastrectomy for gastric cancer: Systematic review and meta-analysis

Caruso¹,

Patriti²,

Roviello³

et al. 2017

WJCO

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AIMTo evaluate the potential effectiveness of robot-assisted gastrectomy (RAG) in comparison to open gastrectomy (OG) for gastric cancer patients.METHODSA comprehensive systematic literature search using PubMed, EMBASE, and the Cochrane Library was carried out to identify studies comparing RAG and OG in gastric cancer. Participants of any age and sex were considered for inclusion in comparative studies of the two techniques independently from type of gastrectomy. A meta-analysis of short-term perioperative outcomes was performed to evaluate whether RAG is equivalent to OG. The primary outcome measures were set for estimated blood loss, operative time, conversion rate, morbidity, and hospital stay. Secondary among postoperative complications, wound infection, bleeding and anastomotic leakage were also analysed.RESULTSA total of 6 articles, 5 retrospective and 1 randomized controlled study, involving 6123 patients overall, with 689 (11.3%) cases submitted to RAG and 5434 (88.7%) to OG, satisfied the eligibility criteria and were included in the meta-analysis. RAG was associated with longer operation time than OG (weighted mean difference 72.20 min; P < 0.001), but with reduction in blood loss and shorter hospital stay (weighted mean difference -166.83 mL and -1.97 d respectively; P < 0.001). No differences were found with respect to overall postoperative complications (P = 0.65), wound infection (P = 0.35), bleeding (P = 0.65), and anastomotic leakage (P = 0.06). The postoperative mortality rates were similar between the two groups. With respect to oncological outcomes, no statistical differences among the number of harvested lymph nodes were found (weighted mean difference -1.12; P = 0.10).CONCLUSIONRAG seems to be a technically valid alternative to OG for performing radical gastrectomy in gastric cancer resulting in safe complications.

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Section: Resultsmentioning

confidence: 99%

Robot-assisted laparoscopic vs open gastrectomy for gastric cancer: Systematic review and meta-analysis

Caruso¹,

Patriti²,

Roviello³

et al. 2017

WJCO

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“…The results of a single-center prospective randomized trial were reported by Wang et al (47) They randomized a total of 311 patients to either open (n=153) or robotic (n=158) gastrectomy groups by the envelope method. They showed similar complication rates between the groups, and less estimated blood loss, longer duration of surgery, and shorter postoperative hospital stay in the robotic group than open group.…”

Section: Prospective Studiesmentioning

confidence: 99%

Robotic gastrectomy for gastric cancer

Tokunaga

Kaito

Sugita

et al. 2017

Transl. Gastroenterol. Hepatol.

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Correspondence to: Masanori Tokunaga. 6-5-1, Kashiwanoha, Kashiwa, 277-8577 Japan. Email: mtokunag@east.ncc.go.jp.Abstract: The number of robotic gastrectomy (RG) performed per year has been increasing, particularly in East Asia where the incidence of gastric cancer is high and approximately half of the cases are diagnosed as early gastric cancer. With articulated devices of RG, surgeons are able to perform every procedure more meticulously, which can result in less bleeding and damage to organs. There are many single arm and comparative studies, and these study showed similar trends, which included relatively less estimated blood loss and longer operation time following RG than laparoscopic gastrectomy (LG), equivalent number of harvested lymph nodes and similar length of postoperative hospital stay between RG and LG. Considering the results of these retrospective comparative studies, RG seems to be as feasible as LG in terms of early surgical outcomes. However, medical expense of RG is approximately twice as much as that of LG. Lack of solid evidence in terms of long-term outcomes is another problem. Considering the higher medical expenses associated with RG, its superiority in terms of long-term survival outcomes needs to be confirmed in the future for it to be accepted more widely.

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“…Recently, Wang et al reported a single-center randomized clinical trial for robotic gastrectomy compared with open gastrectomy [13]. This report showed that robotic gastrectomy group had less blood loss (94.2 ± 51.5 versus 152.8 ± 76.9 ml, p < .001), a shorter hospital stay (5.6 ± 1.9 versus 6.7 ± 1.9 days, p = .021), and earlier recovery of bowel function (2.6 ± 1.1 versus 3.1 ± 1.2 days, p = .028), but a longer operation time (242.7 ± 43.8 versus 192.4 ± 31.5 min, p = .002), than the open gastrectomy group.…”

Section: Overview and Historymentioning

confidence: 99%

“…Compared with open gastrectomy, robotic gastrectomy had a shorter length of postoperative hospital stay [10, 13]. However, most studies showed no difference in length of hospital stay when comparing robotic and laparoscopic gastrectomies.…”

Section: Issues Regarding Robotic Gastrectomymentioning

confidence: 99%

“…Dissecting around the suprapancreatic area is one of the most difficult parts in a laparoscopic gastrectomy. Comparative analyses between robotic and open gastrectomies reported no significant difference in the total number of retrieved lymph nodes [13]. Recent comparative studies between robotic and laparoscopic gastrectomies also showed no difference in the total number of retrieved lymph node [14, 25].…”

Section: Issues Regarding Robotic Gastrectomymentioning

confidence: 99%

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Status and Prospects of Robotic Gastrectomy for Gastric Cancer: Our Experience and a Review of the Literature

Lee

Son

Kim

et al. 2017

Gastroenterology Research and Practice

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Since the first report of robotic gastrectomy, experienced laparoscopic surgeons have used surgical robots to treat gastric cancer and resolve problems associated with laparoscopic gastrectomy. However, compared with laparoscopic gastrectomy, the superiority of robotic procedures has not been clearly proven. There are several advantages to using robotic surgery for gastric cancer, such as reduced estimated blood loss during the operation, a shorter learning curve, and a larger number of examined lymph nodes than conventional laparoscopic gastrectomy. The increased operation time observed with a robotic system is decreasing because surgeons have accumulated experience using this procedure. While there is limited evidence, long-term oncologic outcomes appear to be similar between robotic and laparoscopic gastrectomy. Robotic procedures have a significantly greater financial cost than laparoscopic gastrectomy, which is a major drawback. Recent clinical studies tried to demonstrate that the benefits of robotic surgery outweighed the cost, but the overall results were disappointing. Ongoing studies are investigating the benefits of robotic gastrectomy in more complicated and challenging cases. Well-designed randomized control trials with large sample sizes are needed to investigate the benefits of robotic gastrectomy compared with laparoscopic surgery.

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Assessing the safety and efficacy of full robotic gastrectomy with intracorporeal robot-sewn anastomosis for gastric cancer: A randomized clinical trial

Abstract: Full robotic gastrectomy with intracorporeal robot-sewn anastomosis for gastric cancer is safe and does not increase the complication risk during or after surgery. J. Surg. Oncol. 2016;113:397-404. © 2016 Wiley Periodicals, Inc.

Cited by 59 publications

References 47 publications

Robot-assisted laparoscopic vs open gastrectomy for gastric cancer: Systematic review and meta-analysis

Robot-assisted laparoscopic vs open gastrectomy for gastric cancer: Systematic review and meta-analysis

Robotic gastrectomy for gastric cancer

Status and Prospects of Robotic Gastrectomy for Gastric Cancer: Our Experience and a Review of the Literature

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