Comparison of long-term outcomes after robotic versus laparoscopic radical gastrectomy: a propensity score-matching study

Li, Jintao; Ji, Lin; Wang, Fu-Hai; Wang, Jia-Bin; Lü, Jun; Chen, Qi‐Yue; Cao, Long‐Long; Ma, Lin; Tu, Ru‐Hong; Huang, Ze-Ning; Lin, Ju‐Li; Zheng, Hua-Long; Zheng, Chao‐Hui; Huang, Chang‐Ming; Li, Ping

doi:10.1007/s00464-022-09245-3

Cited by 9 publications

(5 citation statements)

References 39 publications

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“…The number of lymph node dissections is another significant parameter for evaluating ( 24 , 25 ) radical resection in gastric cancer. Prior studies have corroborated that it is simpler to remove lymph nodes in robotic gastrectomy than in laparoscopic gastrectomy ( 26 , 27 ). However, there was no significant difference in the number of lymph node dissections between the laparoscopic group and the robotic group in our study.…”

Section: Discussionmentioning

confidence: 96%

Comparison of short-term outcomes between robotic and laparoscopic distal gastrectomy performed by the same surgical team during the same period

Shen

et al. 2023

Front. Oncol.

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ObjectiveTo evaluate the short-term outcomes of laparoscopic distal gastrectomy and robotic distal gastrectomy performed during the same period.MethodsThis study enrolled 46 cases of laparoscopic distal gastrectomy and 67 cases of robotic distal gastrectomy that were performed by a single surgeon between April 2020 to October 2021. Baseline characteristics and short-term outcomes of these two groups were then compared. Moreover, the robotic distal gastrectomy group was further divided into two subgroups according to the learning curve. Finally, the baseline characteristics and short-term outcomes of both subgroups were compared with the laparoscopic group, respectively.ResultsThe baseline characteristics and short-term outcomes of the LDG group and RDG group were comparable. In contrast, the operation time in the laparoscopic group was significantly shorter than that in the early experience robotic group (191.3 ± 37.6 VS 225.1 ± 49, P=0.001). However, the operation time (191.3 ± 37.6 VS 185.3 ± 25.3, P=0.434) was comparable between the laparoscopic group and the late experience robotic group. Likewise, the bleeding volume was comparable between the laparoscopic and early experience robotic groups. However, bleeding volume was significantly lower in the late experience robotic group compared to that in the laparoscopic group (37.5 ± 18.8 VS 49.2 ± 29.0, P=0.049).ConclusionsWith surgeons stepping into the stable stage of the robotic learning curve, RDG showed a comparable operation time and lower volume of blood loss compared with LDG. Collectively, our study supports the application of robotic distal gastrectomy in patients diagnosed with gastric cancer.

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Section: Discussionmentioning

confidence: 96%

Comparison of short-term outcomes between robotic and laparoscopic distal gastrectomy performed by the same surgical team during the same period

Shen

et al. 2023

Front. Oncol.

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“…A total of 11 retrospective matched-cohort studies have reported 3-or 5-year DFS rates between RG and LG (eTable 5, Supplemental Digital Content 1, http://links.lww. com/SLA/F3), 15,19,[27][28][29][30][31][32][33][34][35] with the majority indicating a slightly better survival by RG. Yet, the majority of these studies were constrained by their single-center methodologies and limited sample sizes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Short-term and Three-year Oncological Outcomes Between Robotic and Laparoscopic Gastrectomy for Gastric Cancer

Lu,

Li,

Zhang

et al. 2024

Annals of Surgery

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Objective: To compare the short- and long-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for gastric cancer. Summary Background Data: The clinical outcomes of RG over LG have not yet been effectively demonstrated. Methods: This retrospective cohort study included 3,599 patients with gastric cancer who underwent radical gastrectomy at eight high-volume hospitals in China from August 2016 to June 2019. Propensity score matching (PSM) was performed between patients who received RG and LG. The primary endpoint was 3-year disease-free survival (DFS). Results: After 1:1 PSM, 1034 pairs of patients were enrolled in a balanced cohort for further analysis. The 3-year DFS in the RG and LG was 83.7% and 83.1% (P=0.745), respectively, and the 3-year overall survival (OS) was 85.2% and 84.4%, respectively (P=0.647). During three years of follow-up, 154 patients in the RG and LG groups relapsed (cumulative incidence of recurrence: 15.0% vs. 15.0%, P=0.988). There was no significant difference in the recurrence sites between the two groups (all P>0.05). Sensitivity analysis showed that RG had comparable 3-year DFS (77.4% vs. 76.7%, P=0.745) and OS (79.7% vs. 78.4%, P=0.577) to LG in patients with advanced (pathological T2-4a) disease, and the recurrence pattern within three years was also similar between the two groups (all P>0.05). RG had less intraoperative blood loss, lower conversion rate, and shorter hospital stays than LG (all P>0.05). Conclusions: For resectable gastric cancer, including advanced cases, RG is a safe approach with comparable 3-year oncological outcomes to LG when performed by experienced surgeons.

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“…The index value was introduced by Sasako et al [ 12 ]. This index is used to evaluate the therapeutic value of dissection of individual lymph node stations in cancer surgeries [ 13 – 15 ]. Similar results were found in our study.…”

Section: Discussionmentioning

confidence: 99%

“…[ 12 ]. This index is used to evaluate the therapeutic value of dissection of individual lymph node stations not only in gastric cancer surgery [ 13 ] but also in other solid organ cancer surgeries such as pancreatic cancer [ 14 ] or colorectal cancer [ 15 ]. The survival benefit gained by dissection of meso-jejunal lymph nodes was calculated by multiplying the frequency of metastasis at the meso-jejunal lymph node station and the 5-year overall survival rate of patients with metastasis at that station.…”

Section: Methodsmentioning

confidence: 99%

Meso-jejunal lymph node dissection has a survival benefit in patients with remnant gastric cancer

Choi

Lee

et al. 2023

PLoS ONE

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Background Clinical benefits of the meso-jejunal lymph node (MJLN) dissection in remnant gastric cancer (RGC) patients have not been fully established. Hence, in this retrospective study, we evaluated the survival benefit of MJLN dissection and prognostic significance of MJLN metastasis in RGC patients who underwent gastrojejunostomy reconstruction after their initial gastrectomy. Methods We retrospectively reviewed 391 patients who underwent surgery for RGC at our institution between 1996 and 2019. Among them, 60 patients had MJLN dissection. The index value of the survival benefit gained by dissection of the MJLN was calculated by multiplying the frequency of metastasis at the MJLN station and the 5-year overall survival rate (5YOS) of patients with metastasis at that station. When the metastatic rate or 5YOS exceeded 10%, dissection was recommended. An index value of dissection greater than 1.0 was considered significant. Results Total metastatic rate of MJLN was 35% (n = 21/60). Patients with MJLN metastasis had advanced pathologic stage compared to patients in the no-metastasis group (p < 0.001). In T2-T4 RGC patients, the metastatic rate of MJLN was 48.6% (n = 17/35), and their 5YOS was 28.4%. The calculated index value was 13.8. Also, patients with MJLN metastasis had a poorer overall survival than those without metastasis. MJLN metastasis was an independent prognostic factor of overall survival in multivariate analysis (HR 6.77, 95%CI 2.21–20.79, p = 0.001). Conclusion MJLN dissection should be considered for advanced RGC patients who underwent gastrojejunostomy after distal gastrectomy during their initial surgery according to the index value.

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Comparison of long-term outcomes after robotic versus laparoscopic radical gastrectomy: a propensity score-matching study

Cited by 9 publications

References 39 publications

Comparison of short-term outcomes between robotic and laparoscopic distal gastrectomy performed by the same surgical team during the same period

Comparison of short-term outcomes between robotic and laparoscopic distal gastrectomy performed by the same surgical team during the same period

Comparison of Short-term and Three-year Oncological Outcomes Between Robotic and Laparoscopic Gastrectomy for Gastric Cancer

Meso-jejunal lymph node dissection has a survival benefit in patients with remnant gastric cancer

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