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A comparative study on perioperative outcomes between robotic versus laparoscopic D2 total gastrectomy
Zhenshun Li1, Feng Qian1, Yongliang Zhao1
1Department of General Surgery, The First Affiliated Hospital of Army Medical University, 30 Gaotanyan Street, Chongqing, 400038, China.
International Journal of Surgery (London, England)
|April 26, 2022
Summary
Robotic total gastrectomy (RTG) shows advantages over laparoscopic total gastrectomy (LTG) for advanced gastric cancer. RTG resulted in less blood loss and more lymph nodes retrieved, with better laboratory results, though complication rates were similar.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Robotic surgery offers advanced features, but its superiority over laparoscopic techniques for total gastrectomy remains under investigation.
- Laparoscopic total gastrectomy (LTG) is a standard minimally invasive approach for gastric cancer.
Purpose of the Study:
- To compare the safety and efficacy of robotic total gastrectomy (RTG) versus LTG with D2 lymphadenectomy for locally advanced gastric cancer (AGC).
Main Methods:
- A prospective cohort study enrolled 155 patients (18-80 years) with locally advanced gastric cancer (cT2-4a, N0/+, M0).
- Perioperative outcomes within 30 days were compared between the RTG (n=69) and LTG (n=73) groups.
- Postoperative complications were assessed using the Clavien-Dindo classification.
Main Results:
- No significant difference in overall postoperative morbidity (21.74% RTG vs. 28.77% LTG).
- RTG showed a lower incidence of pneumonia (4.35% vs. 15.07%, P=0.047), less blood loss (110 vs. 150 ml, P<0.001), and more retrieved lymph nodes (41.36 vs. 35.1, P=0.019).
- RTG group exhibited better laboratory results, including inflammatory markers and lymphocyte levels.
Conclusions:
- Robotic surgery offers advantages over laparoscopic surgery for radical total gastrectomy with D2 lymphadenectomy in patients with locally advanced gastric cancer.
- These benefits are particularly evident when performed by well-trained surgeons.
