Robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: meta-analysis and trial sequential analysis of prospective observational studies

Zheng, Bin; Wang, Xin; Li, Jiang; Wang, Quan; Bi, Lei; Deng, Xia; Wang, Ziqiang

doi:10.1007/s00464-018-06648-z

Cited by 74 publications

(96 citation statements)

References 44 publications

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“…The operative time for RAG is longer than LAG [24] (mean 58 min) which in turn is longer then open surgery (mean 64 min) [30], therefore, making RAG approximately 2 h longer than OG. The reasons for this are multiple, but the docking of the robot can be time consuming, particularly in theatres that use the robot intermittently.…”

Section: Short-term Surgical Outcomesmentioning

confidence: 99%

“…This is the case for those studies assessing RAG vs LAG and those that compare RAG with OG. The most recent study reports a mean reduction of blood loss of 23.7 ml for RAG compared to laparoscopic or open surgery [24]. Although this number is relatively low, differences in blood loss should not be disregarded as unimportant as there is certainly evidence of reduced peri-operative infection rates associated with reduced blood loss [35] and potentially even recurrence rates [36].…”

Section: Short-term Surgical Outcomesmentioning

confidence: 99%

“…There has been no significant difference in any of the studies published to date in terms of conversion to open or laparoscopy or re-operation following index surgery. Equally, peri-operative mortality (both 30 and 90 days) are not significantly different between RAG, LAG and OG (0.4–0.6% [24]). There was no difference observed in anastomotic leak rates between any of the groups.…”

Section: Short-term Surgical Outcomesmentioning

confidence: 99%

“…To date, however, prospective multicentre randomised studies remain lacking, and evidence comprises several case-matched series [e.g. 17–19] and meta-analyses [12, 20–24]. However, the majority of the meta-analyses report on a small number of Asian cohort studies and often compare RAG to both LAG and OG.…”

Section: Introductionmentioning

confidence: 99%

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Robotic-assisted gastrectomy for gastric cancer: a European perspective

2019

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Gastrectomy is the mainstay treatment for gastric cancer. To reduce the associated patient burden, minimally invasive gastrectomy was introduced in almost 30 years ago. The increase in the availability of surgical robotic systems led to the first robotic-assisted gastrectomy to be performed in 2002 in Japan. Robotic gastrectomy however, particularly in Europe, has not yet gained significant traction. Most reports to date are from Asia, predominantly containing observational studies. These cohorts are commonly different in the tumour stage, location (particularly with regards to gastroesophageal junctional tumours) and patient BMI compared to those encountered in Europe. To date, no randomised clinical trials have been performed comparing robotic gastrectomy to either laparoscopic or open equivalent. Cohort studies show that robotic gastrectomy is equal oncological outcomes in terms of survival and lymph node yield. Operative times in the robotic group are consistently longer compared to laparoscopic or open gastrectomy, although evidence is emerging that resectional surgical time is equal. The only reproducibly significant difference in favour of robot-assisted gastrectomy is a reduction in intraoperative blood loss and some studies show a reduction in the risk of pancreatic fistula formation.

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Section: Short-term Surgical Outcomesmentioning

confidence: 99%

Section: Short-term Surgical Outcomesmentioning

confidence: 99%

Section: Short-term Surgical Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Robotic-assisted gastrectomy for gastric cancer: a European perspective

2019

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“…However, some cohort studies reported the same oncological outcomes as survival and lymph node yield. The noticeable difference for RAG was reduction in intraoperative blood loss [75] and the risk of pancreatic fistula formation during dissection and D2 lymphadenectomy with RAG compared to LG [74]. However, higher costs and longer operating times are associated with RAG [75].…”

Section: Gastric Cancermentioning

confidence: 99%

Robots in Cancer Surgery: A Boon or Bane

Jamal¹,

Alshahrani²,

Arif³

et al. 2020

JCT

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The 140 years' journey of gastric cancer surgery: From the two hands of Billroth to the multiple hands of the robot

Terashima

2021

Annals of Gastroent Surgery

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The basis of surgery for gastric cancer is gastrectomy and lymph node dissection. Initially, the effectiveness of extended surgery was shown to improve the therapeutic results; however, the attempts failed to demonstrate its usefulness. After many twists and turns, D2 dissection is now regarded as the standard treatment for advanced gastric cancer.On the other hand, the effectiveness of minimally invasive surgery (MIS) has been verified, and MIS is now positioned as

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Robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: meta-analysis and trial sequential analysis of prospective observational studies

Cited by 74 publications

References 44 publications

Robotic-assisted gastrectomy for gastric cancer: a European perspective

Robotic-assisted gastrectomy for gastric cancer: a European perspective

Robots in Cancer Surgery: A Boon or Bane

The 140 years' journey of gastric cancer surgery: From the two hands of Billroth to the multiple hands of the robot

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