Robotic distal subtotal gastrectomy with D2 lymphadenectomy for gastric cancer patients with high body mass index: comparison with conventional laparoscopic distal subtotal gastrectomy with D2 lymphadenectomy

Lee, Juhan; Kim, Yoo Min; Woo, Yanghee; Obama, Kazutaka; Noh, Sung Hoon; Hyung, Woo Jin

doi:10.1007/s00464-015-4069-1

Cited by 112 publications

(78 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although some have reported feasible long-term survival after RG, the number of patients in each series is too small to obtain any conclusive results (39,40,42). In addition, because survival data is available only from retrospective studies, potential bias could not be eliminated.…”

Section: Discussionmentioning

confidence: 99%

“…Equivalent oncological outcomes have been reported, although selection bias must be taken into account and comparability assessed carefully. Median follow-up periods in RG studies have been relatively short, except for several Korean series with 5-year or longer median followups (39,40,42), and we cannot obtain any conclusive results from these retrospective studies in terms of oncological long-term outcomes of RG. The Korean prospective comparative study may shed light on this issue, although it is not a randomized trial (45).…”

Section: Oncological Outcomesmentioning

confidence: 90%

“…Son et al compared surgical outcomes between 58 patients undergoing laparoscopic and 51 patients undergoing robotic spleen preserving D2 total gastrectomy, and found almost equivalent surgical outcomes with higher numbers of retrieved lymph nodes along the splenic artery after robotic surgery (39). Surgery for obese patients requires a more sophisticated approach and RG could be beneficial, but the potential benefit of RG for these patients is still controversial (38,40). Seo et al paid special attention to the superiority of RG in terms of the incidence of postoperative pancreas fistula, and reported a lower incidence of postoperative pancreas fistula in RG than LG (41).…”

Section: Retrospective Comparative Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Robotic gastrectomy for gastric cancer

Tokunaga

Kaito

Sugita

et al. 2017

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Oncological Outcomesmentioning

confidence: 90%

Section: Retrospective Comparative Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Robotic gastrectomy for gastric cancer

Tokunaga

Kaito

Sugita

et al. 2017

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

show abstract

“…In most series and meta-analyses, the operative time of RAG was longer than in conventional laparoscopic or open surgery [1,10,11,13,16,21]. A more meticulous dissection, particularly along the vessels and during the lymphadenectomy, and an increased preference for intracorporeal anastomosis can partially explain the longer time of robotic procedures [2].…”

Section: Perioperative Outcomesmentioning

confidence: 99%

Robot-assisted gastrectomy for cancer

Bonapasta

Guerra

Linari

et al. 2016

Chirurg

View full text Add to dashboard Cite

show abstract

“…In robotic gastrectomy, about half of all publications report less bleeding than that in laparoscopic surgery (7,17,20,(23)(24)(25)(26)(27)(28). Statistically, less bleeding may have no impact on the clinical course of the patients; however, it implies that robots offer more precise dissection of the lymph nodes following the surgical plane.…”

Section: Less Bleedingmentioning

confidence: 99%

Robotic surgery for gastric tumor: current status and new approaches

Lim

Lee

Son

et al. 2016

Transl. Gastroenterol. Hepatol.

Self Cite

View full text Add to dashboard Cite

Surgical techniques have evolved tremendously over this past century. To maximize the efficacy and minimize the invasiveness of laparoscopic surgery, researchers have sought to implement wider application of robotics. Nevertheless, both optimism without sound evidence and fear of new technology obscure the appropriate uses of robotic surgery. In the present review, we attempted to provide a balanced perspective on the current state of robotic gastrectomy, outlining evidence and opportunities for the use thereof. Although evidence is limited, the use of robotics is feasible for gastric cancer surgery, and less than 10 cases of robotic surgery are needed to become proficient therein. Compared to the clinical impact of laparoscopy on gastric cancer surgery, the additional benefits of robotic surgery to patients seem to be limited. Despite additional costs and longer surgeries, robotic surgery reportedly does not offer surgical outcomes superior to those for laparoscopic surgery, according to a recent multicenter study.Meanwhile, however, our in-depth review of retrospective and prospective reports revealed that robots could expand the indications of minimally invasive gastrectomy for patients requiring total gastrectomy and D2 lymph node dissection. Moreover, we found that robotic gastrectomy is associated with a higher number of retrieved lymph nodes, less bleeding, fewer complications, and shorter hospital stay, compared to laparoscopic gastrectomy. Accordingly, new surgical approaches using advanced technologies, such as near infrared detectors, the Tilepro ® multi-input display, dual consoles, and the Single-Site ® system, are under investigation. In conclusion, measuring the additional benefits of robotic over laparoscopic surgery would be difficult and clinically insignificant. Thus, developing new surgical procedures that extend the benefits of conventional laparoscopic surgery to patients in whom minimally invasive surgery would not be possible is necessary to justify the greater use of robotic surgery.

show abstract

Robotic distal subtotal gastrectomy with D2 lymphadenectomy for gastric cancer patients with high body mass index: comparison with conventional laparoscopic distal subtotal gastrectomy with D2 lymphadenectomy

Cited by 112 publications

References 43 publications

Robotic gastrectomy for gastric cancer

Robotic gastrectomy for gastric cancer

Robot-assisted gastrectomy for cancer

Robotic surgery for gastric tumor: current status and new approaches

Contact Info

Product

Resources

About