Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experience
Abstract Background Reduced-port laparoscopic gastrectomy can potentially reduce postoperative pain and improve recovery time. However, the inherent difficulty caused by the narrow manipulation angle makes this operation difficult, especially during lymph node dissection. The intrinsic advantage of...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-022-01645-5 |
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| author | Chih-Yuan Wang Yu-Hsien Chen Ting-Shuo Huang |
| author_facet | Chih-Yuan Wang Yu-Hsien Chen Ting-Shuo Huang |
| author_sort | Chih-Yuan Wang |
| collection | DOAJ |
| description | Abstract Background Reduced-port laparoscopic gastrectomy can potentially reduce postoperative pain and improve recovery time. However, the inherent difficulty caused by the narrow manipulation angle makes this operation difficult, especially during lymph node dissection. The intrinsic advantage of the da Vinci® robotic system might offset this difficulty, maintaining adequate surgical quality with risks of surgical complications equal to those by the conventional four-port robotic approach. The aim of this study was to compare the reduced-port robotic approach and the conventional four-port approach in terms of postoperative pain and short-term surgical outcomes. Methods All patients who underwent radical gastrectomy with D2 lymph node dissection using the da Vinci Xi robotic system, including reduced-port or conventional four-port approach, were analyzed retrospectively. The primary outcome was postoperative pain assessed using the numerical rating scale (NRS). The secondary outcomes were the number of harvested lymph nodes, operation time, length of hospital stay, and postoperative 30-day complications. Results Forty-eight patients were enrolled in the study, 10 cases in the reduced-port and 38 in the conventional four-port group. Postoperative NRS revealed no significant difference between the reduced-port and conventional four-port groups [postoperative day (POD) 1: 4.5 vs. 3, p = 0.047, POD 3: 4 vs. 3, p = 0.178]. After propensity score matching, there were no significant differences in the median number of harvested lymph nodes, operation time, and length of hospital stay between the groups. The postoperative 30-day complications were more frequent in the conventional four-port group, but there was no significant difference compared with the reduced-port group after propensity score matching. Conclusions Reduced-port robotic gastrectomy with D2 lymph node dissection might be comparable to the conventional four-port robotic operation in terms of postoperative pain, surgical quality, and short-term outcomes. However, further studies are required to confirm our results and clarify the advantages of the robotic reduced-port approach. |
| first_indexed | 2024-04-12T16:12:23Z |
| format | Article |
| id | doaj.art-071b789c5a584830878ed63b7a60e7d2 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-12T16:12:23Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-071b789c5a584830878ed63b7a60e7d22022-12-22T03:25:51ZengBMCBMC Surgery1471-24822022-05-012211710.1186/s12893-022-01645-5Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experienceChih-Yuan Wang0Yu-Hsien Chen1Ting-Shuo Huang2Division of General Surgery, Department of Surgery, Chang Gung Memorial HospitalDivision of General Surgery, Department of Surgery, Chang Gung Memorial HospitalDivision of General Surgery, Department of Surgery, Chang Gung Memorial HospitalAbstract Background Reduced-port laparoscopic gastrectomy can potentially reduce postoperative pain and improve recovery time. However, the inherent difficulty caused by the narrow manipulation angle makes this operation difficult, especially during lymph node dissection. The intrinsic advantage of the da Vinci® robotic system might offset this difficulty, maintaining adequate surgical quality with risks of surgical complications equal to those by the conventional four-port robotic approach. The aim of this study was to compare the reduced-port robotic approach and the conventional four-port approach in terms of postoperative pain and short-term surgical outcomes. Methods All patients who underwent radical gastrectomy with D2 lymph node dissection using the da Vinci Xi robotic system, including reduced-port or conventional four-port approach, were analyzed retrospectively. The primary outcome was postoperative pain assessed using the numerical rating scale (NRS). The secondary outcomes were the number of harvested lymph nodes, operation time, length of hospital stay, and postoperative 30-day complications. Results Forty-eight patients were enrolled in the study, 10 cases in the reduced-port and 38 in the conventional four-port group. Postoperative NRS revealed no significant difference between the reduced-port and conventional four-port groups [postoperative day (POD) 1: 4.5 vs. 3, p = 0.047, POD 3: 4 vs. 3, p = 0.178]. After propensity score matching, there were no significant differences in the median number of harvested lymph nodes, operation time, and length of hospital stay between the groups. The postoperative 30-day complications were more frequent in the conventional four-port group, but there was no significant difference compared with the reduced-port group after propensity score matching. Conclusions Reduced-port robotic gastrectomy with D2 lymph node dissection might be comparable to the conventional four-port robotic operation in terms of postoperative pain, surgical quality, and short-term outcomes. However, further studies are required to confirm our results and clarify the advantages of the robotic reduced-port approach.https://doi.org/10.1186/s12893-022-01645-5GastrectomyGastric cancerLymph node dissectionRobotic surgery |
| spellingShingle | Chih-Yuan Wang Yu-Hsien Chen Ting-Shuo Huang Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experience BMC Surgery Gastrectomy Gastric cancer Lymph node dissection Robotic surgery |
| title | Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experience |
| title_full | Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experience |
| title_fullStr | Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experience |
| title_full_unstemmed | Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experience |
| title_short | Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experience |
| title_sort | reduced port robotic radical gastrectomy for gastric cancer a single institute experience |
| topic | Gastrectomy Gastric cancer Lymph node dissection Robotic surgery |
| url | https://doi.org/10.1186/s12893-022-01645-5 |
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