Perioperative outcomes of robot-assisted versus laparoscopic distal gastrectomy for gastric cancer: a systematic review and meta-analysis of propensity score matching studies

Wei Li ¹, Shou-Jiang Wei ²

⁰Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

Journal of Robotic Surgery +

|

September 4, 2024

View abstract on PubMed

Summary

Robot distal gastrectomy (RDG) offers benefits for gastric cancer patients, including reduced blood loss and shorter hospital stays. However, it involves a longer operative time compared to laparoscopic distal gastrectomy (LDG).

Area Of Science

Surgical Oncology
Minimally Invasive Surgery
Gastrointestinal Surgery

Background

Gastric cancer treatment often involves gastrectomy, with minimally invasive approaches gaining prominence.
Robot-assisted distal gastrectomy (RDG) and laparoscopic distal gastrectomy (LDG) are key minimally invasive techniques.
Comparative efficacy data, particularly from propensity score-matched studies, are crucial for guiding surgical choices.

Purpose Of The Study

To conduct a meta-analysis comparing the efficacy of robot distal gastrectomy (RDG) versus laparoscopic distal gastrectomy (LDG) for gastric cancer.
To focus on studies that employed propensity score matching (PSM) to minimize confounding factors.
To evaluate key perioperative and postoperative outcomes between RDG and LDG.

Main Methods

Systematic literature search of PubMed, Embase, and Google Scholar up to June 2024.
Inclusion of 12 propensity score-matched studies involving 3688 patients.
Assessment of study quality using ROBINS-I and data analysis with Review Manager 5.4.1.

Main Results

RDG demonstrated a significantly longer operative time (WMD 30.64 min) compared to LDG.
RDG resulted in less estimated blood loss (WMD 29.54 mL) and a higher lymph-node yield (WMD 5.14).
Patients undergoing RDG experienced a shorter hospital stay (WMD -0.36 days); no significant differences in time to first flatus or complication rates were observed.

Conclusions

Robot distal gastrectomy for gastric cancer offers advantages in reducing intraoperative blood loss and improving lymph-node dissection.
RDG leads to a shorter hospital stay compared to LDG, despite an increased operative time.
There are no significant differences in the time to first flatus or overall/major complication rates between RDG and LDG.

Keywords:

Distal gastrectomy Gastric cancer Laparoscopic Meta-analysis Robot-assisted

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