Comparison Between Minimally Invasive and Open Gastrectomy for Gastric Cancer in Europe: A Systematic Review and...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Gastric cancer treatment traditionally involves open gastrectomy.
• Laparoscopic and robotic-assisted minimally invasive techniques have emerged as alternatives.
• Comparative effectiveness data for these approaches in European settings are crucial.

Purpose of the Study:

• To compare laparoscopic and robotic gastrectomies with open gastrectomies for gastric cancer in Europe.
• To evaluate the efficacy and safety of minimally invasive versus open gastrectomy.
• To directly compare laparoscopic and robotic gastrectomy techniques.

Main Methods:

• Systematic literature search of PubMed for European studies up to February 2015.
• Inclusion of studies comparing laparoscopic or robotic gastrectomy with open gastrectomy, and direct comparisons between laparoscopic and robotic approaches.
• Analysis of outcomes including lymph node retrieval, leakage, bleeding, mortality, morbidity, and hospital stay.

Main Results:

• No significant differences in lymph node retrieval, leakage, bleeding, or mortality between minimally invasive and open gastrectomies.
• Laparoscopic gastrectomy showed higher overall morbidity than open, while robotic did not differ.
• Minimally invasive approaches resulted in less blood loss and shorter hospital stays compared to open surgery.
• Laparoscopic and robotic procedures had similar outcomes for resection margins and complications, but robotic surgery involved less blood loss and longer operation times.

Conclusions:

• Laparoscopic and robotic gastrectomies are viable alternatives to open surgery for gastric cancer.
• Minimally invasive gastrectomies offer advantages of reduced blood loss and shorter hospital stays.
• Robotic gastrectomy demonstrates less blood loss but a longer operative duration compared to laparoscopic surgery.