Robot versus laparoscopic gastrectomy for cancer by an experienced surgeon: Comparisons of surgery, complications, and surgical stress

Myung Han Hyun, Chung Ho Lee, Ye Ji Kwon, Sung Il Cho, You Jin Jang, Dong Hoon Kim, Jong Han Kim, Seong Heum Park, Young Jae Mok, Sung Soo Park

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90 Citations (Scopus)

Abstract

Background: No previous robotic studies present an equivalent surgical quality comparison in an experienced setting for gastric cancer. In addition, a reliable postoperative complication assessment is needed to accurately evaluate surgical outcomes. Methods: After 20 cases of robotic-assisted gastrectomy (RAG), a total of 121 consecutive gastric cancer patients underwent gastrectomy (38 RAG vs 83 laparoscopic-assisted gastrectomy [LAG]) from February 2009 to November 2010 at the Department of Surgery, Korea University Anam Hospital, Seoul, Korea. The Clavien-Dindo (C-D) classification was used to classify surgical complications. The granulocyte-to-lymphocyte (G:L) ratio was analyzed to evaluate surgical stress. Results: The baseline characteristics, with the exception of age, were similar. The mean total operation time for RAG (234.4 ± 48.0 min) was not significantly different than that for LAG (220.0 ± 60.6 min; P = 0.198). However, in obese patients, fewer lymph nodes were harvested by RAG (23.4 ± 7.0) than by LAG (32.2 ± 12.5, P = 0.006). Overall C-D complications were more common for RAG (47.3 vs 38.5 %), but the difference was not significant (P = 0.361). The mean hospital stay was similar for the 2 groups. Surgical stress as estimated by the G:L ratio was comparable between the 2 groups. Conclusions: RAG performed by an experienced surgeon resulted in similar postoperative outcomes and complications to those of LAG. Assessment of operation time, C-D complication grade, and G:L ratio revealed that RAG is a practical and feasible alternative to LAG, with the possible exception of obese patients.

Original languageEnglish
Pages (from-to)1258-1265
Number of pages8
JournalAnnals of Surgical Oncology
Volume20
Issue number4
DOIs
Publication statusPublished - 2013 Apr

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Hyun, M. H., Lee, C. H., Kwon, Y. J., Cho, S. I., Jang, Y. J., Kim, D. H., Kim, J. H., Park, S. H., Mok, Y. J., & Park, S. S. (2013). Robot versus laparoscopic gastrectomy for cancer by an experienced surgeon: Comparisons of surgery, complications, and surgical stress. Annals of Surgical Oncology, 20(4), 1258-1265. https://doi.org/10.1245/s10434-012-2679-6