Skip to main content
Top
Published in: Surgical Endoscopy 5/2012

01-05-2012

Robot-assisted total gastrectomy is comparable with laparoscopically assisted total gastrectomy for early gastric cancer

Authors: Hong Man Yoon, Young-Woo Kim, Jun Ho Lee, Keun Won Ryu, Bang Wool Eom, Ji Yeon Park, Il Ju Choi, Chan Gyoo Kim, Jong Yeul Lee, Soo Jeong Cho, Ji Yoon Rho

Published in: Surgical Endoscopy | Issue 5/2012

Login to get access

Abstract

Background

Laparoscopically assisted total gastrectomy (LATG) is technically difficult. Robot surgery has theoretical advantages such as increased degrees of freedom of instruments and a three-dimensional view. The current study aimed to determine whether a robot-assisted total gastrectomy (RATG) has a real benefit over LATG in terms of surgical and oncologic outcomes.

Methods

A single-center case–control study was conducted. The study included 36 patients who underwent RATG and 65 patients who underwent LATG at the National Cancer Center in Korea between February 2009 and May 2011. No patients were excluded from the analysis within the study period. Clinicopathologic data, operative data, postoperative morbidity, and pathologic data were analyzed by Student’s t-tests and Chi-square tests, as indicated.

Results

The mean age of the patients was 53.9 ± 11.7 years in the RATG group and 56.9 ± 12.3 years in the LATG group (P = 0.236). The mean BMI was 23.2 ± 2.5 kg/m2 in the RATG group and 23.6 ± 3.4 kg/m2 in the LATG group (P = 0.494). The mean postoperative hospital stay was 8.8 ± 3.3 days in the RATG group and 10.3 ± 10.8 days in the LATG group (P = 0.416). The mean operative time was 305.8 ± 115.8 min in the RATG group and 210.2 ± 57.7 min in the LATG group (P < 0.001). The mean number of dissected lymph nodes was 42.8 ± 12.7 in the RATG group and 39.4 ± 13.4 in the LATG group (P = 0.209). Postoperative complications were experienced by 6 patients (16.7%) in the RATG group and 10 patients (15.4%) in the LATG group (P = 0.866).

Conclusion

Despite early experiences, RATG was shown to be comparable with LATG in terms of surgical and oncologic outcomes. However, no apparent benefit is associated with RATG to date.
Literature
1.
go back to reference Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4:146–148PubMed Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4:146–148PubMed
2.
go back to reference Kim YW, Baik YH, Yun YH, Nam BH, Kim DH, Choi IJ, Bae JM (2008) Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg 248:721–727PubMedCrossRef Kim YW, Baik YH, Yun YH, Nam BH, Kim DH, Choi IJ, Bae JM (2008) Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg 248:721–727PubMedCrossRef
3.
go back to reference Lee SE, Ryu KW, Nam BH, Lee JH, Kim Y-W, Yu JS, Cho SJ, Lee JY, Kim CG, Choi IJ, Kook MC, Park SR, Kim MJ, Lee JS (2009) Technical feasibility and safety of laparoscopy-assisted total gastrectomy in gastric cancer: a comparative study with laparoscopy-assisted distal gastrectomy. J Surg Oncol 100:392–395PubMedCrossRef Lee SE, Ryu KW, Nam BH, Lee JH, Kim Y-W, Yu JS, Cho SJ, Lee JY, Kim CG, Choi IJ, Kook MC, Park SR, Kim MJ, Lee JS (2009) Technical feasibility and safety of laparoscopy-assisted total gastrectomy in gastric cancer: a comparative study with laparoscopy-assisted distal gastrectomy. J Surg Oncol 100:392–395PubMedCrossRef
4.
go back to reference Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J (2001) Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 25:1467–1477PubMed Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J (2001) Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 25:1467–1477PubMed
5.
6.
go back to reference Anderson C, Ellenhorn J, Hellan M, Pigazzi A (2007) Pilot series of robot-assisted laparoscopic subtotal gastrectomy with extended lymphadenectomy for gastric cancer. Surg Endosc 21:1662–1666PubMedCrossRef Anderson C, Ellenhorn J, Hellan M, Pigazzi A (2007) Pilot series of robot-assisted laparoscopic subtotal gastrectomy with extended lymphadenectomy for gastric cancer. Surg Endosc 21:1662–1666PubMedCrossRef
7.
go back to reference Patriti A, Ceccarelli G, Bellochi R, Bartoli A, Spaziani A, Di Zitti L, Casciola L (2008) Robot-assisted laparoscopic total and partial gastric resection with D2 lymph node dissection for adenocarcinoma. Surg Endosc 22:2753–2760PubMedCrossRef Patriti A, Ceccarelli G, Bellochi R, Bartoli A, Spaziani A, Di Zitti L, Casciola L (2008) Robot-assisted laparoscopic total and partial gastric resection with D2 lymph node dissection for adenocarcinoma. Surg Endosc 22:2753–2760PubMedCrossRef
8.
go back to reference Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH (2009) Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg 249:927–932PubMedCrossRef Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH (2009) Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg 249:927–932PubMedCrossRef
9.
go back to reference Woo Y, Hyung WJ, Pak KH, Inaba K, Obama K, Choi SH, Noh SH (2011) Robotic gastrectomy as an oncologically sound alternative to laparoscopic resections for the treatment of early-stage gastric cancers. Arch Surg 146(9):1086–1092 Woo Y, Hyung WJ, Pak KH, Inaba K, Obama K, Choi SH, Noh SH (2011) Robotic gastrectomy as an oncologically sound alternative to laparoscopic resections for the treatment of early-stage gastric cancers. Arch Surg 146(9):1086–1092
10.
go back to reference Scozzari G, Rebecchi F, Millo P, Rocchietto S, Allieta R, Morino M (2011) Robot-assisted gastrojejunal anastomosis does not improve the results of the laparoscopic Roux-en-Y gastric bypass. Surg Endosc 25:597–603PubMedCrossRef Scozzari G, Rebecchi F, Millo P, Rocchietto S, Allieta R, Morino M (2011) Robot-assisted gastrojejunal anastomosis does not improve the results of the laparoscopic Roux-en-Y gastric bypass. Surg Endosc 25:597–603PubMedCrossRef
11.
go back to reference Park J, Choi G-S, Lim K, Jang Y, Jun S (2011) S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc 25:240–248PubMedCrossRef Park J, Choi G-S, Lim K, Jang Y, Jun S (2011) S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc 25:240–248PubMedCrossRef
12.
go back to reference Sarlos D, Kots L, Stevanovic N, Schaer G (2010) Robotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of a matched case–control study. Eur J Obstet Gynecol Reprod Biol 150:92–96PubMedCrossRef Sarlos D, Kots L, Stevanovic N, Schaer G (2010) Robotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of a matched case–control study. Eur J Obstet Gynecol Reprod Biol 150:92–96PubMedCrossRef
13.
go back to reference Link RE, Bhayani SB, Kavoussi LR (2006) A prospective comparison of robotic and laparoscopic pyeloplasty. Ann Surg 243:486–491PubMedCrossRef Link RE, Bhayani SB, Kavoussi LR (2006) A prospective comparison of robotic and laparoscopic pyeloplasty. Ann Surg 243:486–491PubMedCrossRef
14.
go back to reference Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH (2009) Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc 23:1204–1211PubMedCrossRef Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH (2009) Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc 23:1204–1211PubMedCrossRef
15.
go back to reference Kim MC, Heo GU, Jung GJ (2010) Robotic gastrectomy for gastric cancer: surgical techniques and clinical merits. Surg Endosc 24:610–615PubMedCrossRef Kim MC, Heo GU, Jung GJ (2010) Robotic gastrectomy for gastric cancer: surgical techniques and clinical merits. Surg Endosc 24:610–615PubMedCrossRef
16.
go back to reference Hur H, Kim JY, Cho YK, Han SU (2010) Technical feasibility of robot-sewn anastomosis in robotic surgery for gastric cancer. J Laparoendosc Adv Surg Tech A 20:693–697PubMedCrossRef Hur H, Kim JY, Cho YK, Han SU (2010) Technical feasibility of robot-sewn anastomosis in robotic surgery for gastric cancer. J Laparoendosc Adv Surg Tech A 20:693–697PubMedCrossRef
17.
go back to reference Jayaraman S, Quan D, Al-Ghamdi I, El-Deen F, Schlachta C (2010) Does robotic assistance improve efficiency in performing complex minimally invasive surgical procedures? Surg Endosc 24:584–588PubMedCrossRef Jayaraman S, Quan D, Al-Ghamdi I, El-Deen F, Schlachta C (2010) Does robotic assistance improve efficiency in performing complex minimally invasive surgical procedures? Surg Endosc 24:584–588PubMedCrossRef
18.
go back to reference Stefanidis D, Wang F, Korndorffer J, Dunne J, Scott D (2010) Robotic assistance improves intracorporeal suturing performance and safety in the operating room while decreasing operator workload. Surg Endosc 24:377–382PubMedCrossRef Stefanidis D, Wang F, Korndorffer J, Dunne J, Scott D (2010) Robotic assistance improves intracorporeal suturing performance and safety in the operating room while decreasing operator workload. Surg Endosc 24:377–382PubMedCrossRef
19.
go back to reference Byrn JC, Schluender S, Divino CM, Conrad J, Gurland B, Shlasko E, Szold A (2007) Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System. Am J Surg 193:519–522PubMedCrossRef Byrn JC, Schluender S, Divino CM, Conrad J, Gurland B, Shlasko E, Szold A (2007) Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System. Am J Surg 193:519–522PubMedCrossRef
Metadata
Title
Robot-assisted total gastrectomy is comparable with laparoscopically assisted total gastrectomy for early gastric cancer
Authors
Hong Man Yoon
Young-Woo Kim
Jun Ho Lee
Keun Won Ryu
Bang Wool Eom
Ji Yeon Park
Il Ju Choi
Chan Gyoo Kim
Jong Yeul Lee
Soo Jeong Cho
Ji Yoon Rho
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 5/2012
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-011-2043-0

Other articles of this Issue 5/2012

Surgical Endoscopy 5/2012 Go to the issue