Fluorescence-guided Two-port Robotic Gastrectomy Versus Conventional Laparoscopic Gastrectomy: A Nonrandomized...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• The advantages of robotic surgery over laparoscopic surgery for gastric cancer remain unclear.
• Robotic systems offer potential benefits for lymphadenectomy and patient recovery in gastric cancer surgery.

Purpose of the Study:

• To compare lymph node retrieval between conventional laparoscopic gastrectomy (CLG) and integrated robotic gastrectomy (IRG) with fluorescence guidance and a two-port system.
• To evaluate perioperative outcomes including complications, hospital stay, pain, body image, and cost.

Main Methods:

• A nonrandomized controlled trial involving 140 patients undergoing minimally invasive subtotal gastrectomy for early gastric cancer.
• Patients were divided into IRG (n=64) and CLG (n=60) groups.
• Primary endpoint was the number of retrieved lymph nodes; secondary endpoints included complications, hospital stay, and body image.

Main Results:

• The IRG group retrieved significantly more lymph nodes than the CLG group (42.1 vs 35.1, P=0.019).
• IRG also demonstrated a shorter hospital stay (4.1 vs 5.2 days, P<0.001) and improved body image scores.
• No significant difference in complications or pain scores was reported.

Conclusions:

• Integrated robotic gastrectomy with fluorescence and a reduced-port system leads to superior lymph node retrieval.
• IRG offers enhanced perioperative outcomes, including shorter hospital stays and better postoperative body image, compared to CLG.