Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2019

Open Access 01-12-2019 | Gastrectomy | Research

Short- and long-term outcomes of totally robotic versus robotic-assisted radical distal gastrectomy for advanced gastric cancer: a mono-institution retrospective study

Authors: Rui Luo, Dongning Liu, Shanping Ye, Hechun Tang, Weiquan Zhu, Penghui He, Cheng Tang, Taiyuan Li

Published in: World Journal of Surgical Oncology | Issue 1/2019

Login to get access

Abstract

Purpose

By comparing short- and long-term outcomes following totally robotic radical distal gastrectomy (TRDG) and robotic-assisted radical distal gastrectomy (RADG), we aimed to assess in which modus operandi patients will benefit more.

Methods

From January 2015 to May 2019, we included 332 patients undergone RADG (237) and TRDG (95). Based on the propensity score matching (PSM), inclusion and exclusion criteria, 246 patients were finally included in the propensity score-matched cohort including RADG group (164) and TRDG group (82). We then compared the short- and long-term outcomes following both groups.

Results

Propensity score-matched cohort revealed no significant differences in both groups. Intra-abdominal bleeding, time to pass flatus, postoperative activity time, length of incision hospital stays, and stress response were significantly less in TRDG group than in RADG group. We observed 30 complications in RADG group while 13 complications in TRDG group. There were no significant differences in TRDG group and RADG group in terms of operation time, time for anastomosis, proximal resection, distal resection margin, number of lymph node resection, and total hospitalization cost. Both 3-year overall survival and 3-year disease-free survival were comparable in both groups.

Conclusions

TRDG is a safe and feasible modus operandi profiting from short- and long-term outcomes compared with RADG. As surgeons improving their professional skills, TRDG could serve as the standard procedure for distal locally advanced gastric cancer with D2 lymphadenectomy.
Literature
1.
go back to reference Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. United States. 2018;68:394–424.CrossRef Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. United States. 2018;68:394–424.CrossRef
2.
go back to reference Mu G-C, Huang Y, Liu Z-M, Chen Z-B, Wu X-H, Qin X-G, et al. Relationship between celiac artery variation and number of lymph nodes dissection in gastric cancer surgery. World J Gastrointest Oncol China. 2019;11:499–508.CrossRef Mu G-C, Huang Y, Liu Z-M, Chen Z-B, Wu X-H, Qin X-G, et al. Relationship between celiac artery variation and number of lymph nodes dissection in gastric cancer surgery. World J Gastrointest Oncol China. 2019;11:499–508.CrossRef
3.
go back to reference Seo WJ, Son T, Roh CK, Cho M, Kim H-I, Hyung WJ. Reduced-port totally robotic distal subtotal gastrectomy with lymph node dissection for gastric cancer: a modified technique using single-site ((R)) and two additional ports. Surg Endosc Germany. 2018;32:3713–9.CrossRef Seo WJ, Son T, Roh CK, Cho M, Kim H-I, Hyung WJ. Reduced-port totally robotic distal subtotal gastrectomy with lymph node dissection for gastric cancer: a modified technique using single-site ((R)) and two additional ports. Surg Endosc Germany. 2018;32:3713–9.CrossRef
4.
go back to reference Chen K, Pan Y, Zhang B, Maher H, Wang X-F, Cai X-J. Robotic versus laparoscopic gastrectomy for gastric cancer: a systematic review and updated meta-analysis. BMC Surg England. 2017;17:93.CrossRef Chen K, Pan Y, Zhang B, Maher H, Wang X-F, Cai X-J. Robotic versus laparoscopic gastrectomy for gastric cancer: a systematic review and updated meta-analysis. BMC Surg England. 2017;17:93.CrossRef
5.
go back to reference Shen L, Shan Y-S, Hu H-M, Price TJ, Sirohi B, Yeh K-H, et al. Management of gastric cancer in Asia: resource-stratified guidelines. Lancet Oncol England. 2013;14:e535–47.CrossRef Shen L, Shan Y-S, Hu H-M, Price TJ, Sirohi B, Yeh K-H, et al. Management of gastric cancer in Asia: resource-stratified guidelines. Lancet Oncol England. 2013;14:e535–47.CrossRef
6.
go back to reference Braumann C, Jacobi CA, Menenakos C, Ismail M, Rueckert JC, Mueller JM. Robotic-assisted laparoscopic and thoracoscopic surgery with the da Vinci system: a 4-year experience in a single institution. Surg Laparosc Endosc Percutan Tech United States. 2008;18:260–6.CrossRef Braumann C, Jacobi CA, Menenakos C, Ismail M, Rueckert JC, Mueller JM. Robotic-assisted laparoscopic and thoracoscopic surgery with the da Vinci system: a 4-year experience in a single institution. Surg Laparosc Endosc Percutan Tech United States. 2008;18:260–6.CrossRef
7.
go back to reference Obama K, Kim Y-M, Kang DR, Son T, Kim H-I, Noh SH, et al. Long-term oncologic outcomes of robotic gastrectomy for gastric cancer compared with laparoscopic gastrectomy. Gastric Cancer Japan. 2018;21:285–95.CrossRef Obama K, Kim Y-M, Kang DR, Son T, Kim H-I, Noh SH, et al. Long-term oncologic outcomes of robotic gastrectomy for gastric cancer compared with laparoscopic gastrectomy. Gastric Cancer Japan. 2018;21:285–95.CrossRef
8.
go back to reference van Boxel GI, Ruurda JP, van Hillegersberg R. Robotic-assisted gastrectomy for gastric cancer: a European perspective. Japan: Gastric Cancer; 2019. van Boxel GI, Ruurda JP, van Hillegersberg R. Robotic-assisted gastrectomy for gastric cancer: a European perspective. Japan: Gastric Cancer; 2019.
9.
go back to reference Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer Japan. 2017;20:1–19.CrossRef Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer Japan. 2017;20:1–19.CrossRef
10.
go back to reference Takiguchi S, Fujiwara Y, Yamasaki M, Miyata H, Nakajima K, Sekimoto M, et al. Laparoscopy-assisted distal gastrectomy versus open distal gastrectomy. A prospective randomized single-blind study. World J Surg United States. 2013;37:2379–86.CrossRef Takiguchi S, Fujiwara Y, Yamasaki M, Miyata H, Nakajima K, Sekimoto M, et al. Laparoscopy-assisted distal gastrectomy versus open distal gastrectomy. A prospective randomized single-blind study. World J Surg United States. 2013;37:2379–86.CrossRef
11.
go back to reference Ajani JA, D’Amico TA, Almhanna K, Bentrem DJ, Chao J, Das P, et al. Gastric cancer, version 3.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw United States. 2016;14:1286–312.CrossRef Ajani JA, D’Amico TA, Almhanna K, Bentrem DJ, Chao J, Das P, et al. Gastric cancer, version 3.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw United States. 2016;14:1286–312.CrossRef
12.
go back to reference Kwak M, Kim C. Disparities by age, sex, tumor stage, diagnosis path, and area-level socioeconomic status in survival time for major cancers: results from the Busan Cancer Registry. J Korean Med Sci Korea (South). 2017;32:1974–83.CrossRef Kwak M, Kim C. Disparities by age, sex, tumor stage, diagnosis path, and area-level socioeconomic status in survival time for major cancers: results from the Busan Cancer Registry. J Korean Med Sci Korea (South). 2017;32:1974–83.CrossRef
13.
go back to reference Okabe H, Obama K, Tsunoda S, Matsuo K, Tanaka E, Hisamori S, et al. Feasibility of robotic radical gastrectomy using a monopolar device for gastric cancer. Japan: Surg Today; 2019.CrossRef Okabe H, Obama K, Tsunoda S, Matsuo K, Tanaka E, Hisamori S, et al. Feasibility of robotic radical gastrectomy using a monopolar device for gastric cancer. Japan: Surg Today; 2019.CrossRef
14.
go back to reference Zhang S, Khaliq J, Li D, Jiang X, Sun R, Li Y. Robotic total gastrectomy with pi-shaped esophagojejunostomy using a linear stapler as a novel technique. World J Surg Oncol England. 2018;16:238.CrossRef Zhang S, Khaliq J, Li D, Jiang X, Sun R, Li Y. Robotic total gastrectomy with pi-shaped esophagojejunostomy using a linear stapler as a novel technique. World J Surg Oncol England. 2018;16:238.CrossRef
15.
go back to reference Ceccarelli G, Marano L, Codacci-Pisanelli M, Andolfi E, Biancafarina A, Fabozzi M, et al. A new robot-assisted Billroth-I reconstruction: details of the technique and early results. Surg Laparosc Endosc Percutan Tech United States. 2018;28:e33–9. Ceccarelli G, Marano L, Codacci-Pisanelli M, Andolfi E, Biancafarina A, Fabozzi M, et al. A new robot-assisted Billroth-I reconstruction: details of the technique and early results. Surg Laparosc Endosc Percutan Tech United States. 2018;28:e33–9.
16.
go back to reference Kitagami H, Nonoyama K, Yasuda A, Kurashima Y, Watanabe K, Fujihata S, et al. Technique of totally robotic delta-shaped anastomosis in distal gastrectomy. J Minim Access Surg India. 2017;13:215–8. Kitagami H, Nonoyama K, Yasuda A, Kurashima Y, Watanabe K, Fujihata S, et al. Technique of totally robotic delta-shaped anastomosis in distal gastrectomy. J Minim Access Surg India. 2017;13:215–8.
17.
go back to reference Aisu Y, Kadokawa Y, Kato S, Yasukawa D, Kimura Y, Hori T. Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file. Surg Case Rep Germany. 2018;4:16.CrossRef Aisu Y, Kadokawa Y, Kato S, Yasukawa D, Kimura Y, Hori T. Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file. Surg Case Rep Germany. 2018;4:16.CrossRef
18.
go back to reference Dai H-B, Wang Z-C, Feng X-B, Wang G, Li W-Y, Hang C-H, et al. Case report about a successful full robotic radical gastric cancer surgery with intracorporeal robot-sewn anastomosis in a patient with situs inversus totalis and a two-and-a-half-year follow-up study. World J Surg Oncol England. 2018;16:41.CrossRef Dai H-B, Wang Z-C, Feng X-B, Wang G, Li W-Y, Hang C-H, et al. Case report about a successful full robotic radical gastric cancer surgery with intracorporeal robot-sewn anastomosis in a patient with situs inversus totalis and a two-and-a-half-year follow-up study. World J Surg Oncol England. 2018;16:41.CrossRef
20.
go back to reference Mari GM, Crippa J, Costanzi ATM, Pellegrino R, Siracusa C, Berardi V, et al. Intracorporeal anastomosis reduces surgical stress response in laparoscopic right hemicolectomy: a prospective randomized trial. Surg Laparosc Endosc Percutan Tech. 2018;00:1–5. Mari GM, Crippa J, Costanzi ATM, Pellegrino R, Siracusa C, Berardi V, et al. Intracorporeal anastomosis reduces surgical stress response in laparoscopic right hemicolectomy: a prospective randomized trial. Surg Laparosc Endosc Percutan Tech. 2018;00:1–5.
21.
go back to reference Janež J, Korać T, Kodre AR, Jelenc F, Ihan A. Laparoscopically assisted colorectal surgery provides better short-term clinical and inflammatory outcomes compared to open colorectal surgery. Arch Med Sci. 2015;11(6):1217.CrossRef Janež J, Korać T, Kodre AR, Jelenc F, Ihan A. Laparoscopically assisted colorectal surgery provides better short-term clinical and inflammatory outcomes compared to open colorectal surgery. Arch Med Sci. 2015;11(6):1217.CrossRef
22.
go back to reference Bulut O, Aslak KK, Levic K, Nielsen CB, Christensen IJ, Nielsen HJ. A randomized pilot study on single-port versus conventional laparoscopic rectal surgery: effects on postoperative pain and the stress response to surgery; 2014. Bulut O, Aslak KK, Levic K, Nielsen CB, Christensen IJ, Nielsen HJ. A randomized pilot study on single-port versus conventional laparoscopic rectal surgery: effects on postoperative pain and the stress response to surgery; 2014.
23.
go back to reference Lingohr P, Dohmen J, Matthaei H, Konieczny N, Hoffmann J, Bölke E, et al. Cytokine expression in the visceral adipose tissue after laparoscopic and conventional surgery in a rodent model. Eur J Med Res BioMed Central. 2016;21:1–6. Lingohr P, Dohmen J, Matthaei H, Konieczny N, Hoffmann J, Bölke E, et al. Cytokine expression in the visceral adipose tissue after laparoscopic and conventional surgery in a rodent model. Eur J Med Res BioMed Central. 2016;21:1–6.
24.
go back to reference Sciences M. Surgical and not analgesic technique affects postoperative inflammation following colorectal cancer surgery: a prospective, randomized study; 2017. Sciences M. Surgical and not analgesic technique affects postoperative inflammation following colorectal cancer surgery: a prospective, randomized study; 2017.
Metadata
Title
Short- and long-term outcomes of totally robotic versus robotic-assisted radical distal gastrectomy for advanced gastric cancer: a mono-institution retrospective study
Authors
Rui Luo
Dongning Liu
Shanping Ye
Hechun Tang
Weiquan Zhu
Penghui He
Cheng Tang
Taiyuan Li
Publication date
01-12-2019
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2019
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-019-1722-5

Other articles of this Issue 1/2019

World Journal of Surgical Oncology 1/2019 Go to the issue