Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a propensity score‑matched analysis of 1164 patients
Abstract Background Studies on surgical outcomes after robotic surgery are increasing; however, long-term oncological results of studies comparing robotic-assisted distal gastrectomy (RADG) versus laparoscopic-assisted distal gastrectomy (LADG) for advanced gastric cancer (AGC) are still limited. Th...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-022-02778-w |
| _version_ | 1797998417309335552 |
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| author | Gengmei Gao Hualin Liao Qunguang Jiang Dongning Liu Taiyuan Li |
| author_facet | Gengmei Gao Hualin Liao Qunguang Jiang Dongning Liu Taiyuan Li |
| author_sort | Gengmei Gao |
| collection | DOAJ |
| description | Abstract Background Studies on surgical outcomes after robotic surgery are increasing; however, long-term oncological results of studies comparing robotic-assisted distal gastrectomy (RADG) versus laparoscopic-assisted distal gastrectomy (LADG) for advanced gastric cancer (AGC) are still limited. This study aimed to assess the surgical and oncological outcomes of RADG and LADG for the treatment of AGC. Methods A total of 1164 consecutive AGC patients undergoing RADG or LADG were enrolled between January 2015 and October 2021. Propensity score-matched (PSM) analysis was performed to minimize selection bias. The perioperative and oncological outcomes between the two groups were compared. Results Patient’s characteristics were comparable between the two groups after PSM. RADG group represented a longer operative time (205.2 ± 43.1 vs 185.3 ± 42.8 min, P < 0.001), less operative blood loss (139.3 ± 97.8 vs 167.3 ± 134.2 ml, P < 0.001), greater retrieved lymph nodes (LNs) number (31.4 ± 12.1 vs 29.4 ± 12.3, P = 0.015), more retrieved LNs in the supra-pancreatic areas (13.4 ± 5.0 vs 11.4 ± 5.1, P < 0.001), and higher medical costs (13,608 ± 4326 vs 10,925 ± US $3925, P < 0.001) than LADG group. The overall complication rate was 13.7% in the RADG group and 16.6% in the LADG group, respectively; the difference was not significantly different (P = 0.242). In the subgroup analysis, the benefits of RADG were more evident in high BMI patients. Moreover, the 3-year overall survival (75.5% vs 73.1%, P = 0.471) and 3-year disease-free survival (72.9% vs 71.4%, P = 0.763) were similar between the two groups. Conclusion RADG appears to be a safe and feasible procedure and could serve as an alternative treatment for AGC in experienced centers. |
| first_indexed | 2024-04-11T10:48:25Z |
| format | Article |
| id | doaj.art-10cd8029c71d4c7ebb577e84b0f1cf39 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-11T10:48:25Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-10cd8029c71d4c7ebb577e84b0f1cf392022-12-22T04:28:58ZengBMCWorld Journal of Surgical Oncology1477-78192022-09-0120111210.1186/s12957-022-02778-wSurgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a propensity score‑matched analysis of 1164 patientsGengmei Gao0Hualin Liao1Qunguang Jiang2Dongning Liu3Taiyuan Li4The Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanchang University, Jiangxi ProvinceThe Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanchang University, Jiangxi ProvinceThe Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanchang University, Jiangxi ProvinceThe Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanchang University, Jiangxi ProvinceThe Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanchang University, Jiangxi ProvinceAbstract Background Studies on surgical outcomes after robotic surgery are increasing; however, long-term oncological results of studies comparing robotic-assisted distal gastrectomy (RADG) versus laparoscopic-assisted distal gastrectomy (LADG) for advanced gastric cancer (AGC) are still limited. This study aimed to assess the surgical and oncological outcomes of RADG and LADG for the treatment of AGC. Methods A total of 1164 consecutive AGC patients undergoing RADG or LADG were enrolled between January 2015 and October 2021. Propensity score-matched (PSM) analysis was performed to minimize selection bias. The perioperative and oncological outcomes between the two groups were compared. Results Patient’s characteristics were comparable between the two groups after PSM. RADG group represented a longer operative time (205.2 ± 43.1 vs 185.3 ± 42.8 min, P < 0.001), less operative blood loss (139.3 ± 97.8 vs 167.3 ± 134.2 ml, P < 0.001), greater retrieved lymph nodes (LNs) number (31.4 ± 12.1 vs 29.4 ± 12.3, P = 0.015), more retrieved LNs in the supra-pancreatic areas (13.4 ± 5.0 vs 11.4 ± 5.1, P < 0.001), and higher medical costs (13,608 ± 4326 vs 10,925 ± US $3925, P < 0.001) than LADG group. The overall complication rate was 13.7% in the RADG group and 16.6% in the LADG group, respectively; the difference was not significantly different (P = 0.242). In the subgroup analysis, the benefits of RADG were more evident in high BMI patients. Moreover, the 3-year overall survival (75.5% vs 73.1%, P = 0.471) and 3-year disease-free survival (72.9% vs 71.4%, P = 0.763) were similar between the two groups. Conclusion RADG appears to be a safe and feasible procedure and could serve as an alternative treatment for AGC in experienced centers.https://doi.org/10.1186/s12957-022-02778-wAdvanced gastric cancerRobotic distal gastrectomyLaparoscopic distal gastrectomyOncologic outcome |
| spellingShingle | Gengmei Gao Hualin Liao Qunguang Jiang Dongning Liu Taiyuan Li Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a propensity score‑matched analysis of 1164 patients World Journal of Surgical Oncology Advanced gastric cancer Robotic distal gastrectomy Laparoscopic distal gastrectomy Oncologic outcome |
| title | Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a propensity score‑matched analysis of 1164 patients |
| title_full | Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a propensity score‑matched analysis of 1164 patients |
| title_fullStr | Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a propensity score‑matched analysis of 1164 patients |
| title_full_unstemmed | Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a propensity score‑matched analysis of 1164 patients |
| title_short | Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a propensity score‑matched analysis of 1164 patients |
| title_sort | surgical and oncological outcomes of robotic versus laparoscopic assisted distal gastrectomy with d2 lymphadenectomy for advanced gastric cancer a propensity score matched analysis of 1164 patients |
| topic | Advanced gastric cancer Robotic distal gastrectomy Laparoscopic distal gastrectomy Oncologic outcome |
| url | https://doi.org/10.1186/s12957-022-02778-w |
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