Robot-Assisted versus Totally Laparoscopic Distal Gastrectomy for Gastric Cancer: A Retrospective Propensity Score-Matched Analysis

Soo Yeon Baek, Chang Seok Ko, Amy Kim, Byung Sik Kim and In Seob Lee*

Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea

^*Correspondance to: In Seob Lee 

 PDF  Full Text DOI: 10.25107/2474-1647.2764

Abstract

Background: Robot-assisted gastrectomy is increasingly performed, but rarely reported for deltashaped anastomosis. This study compared surgical outcomes of Robot-Assisted Laparoscopic Distal Gastrectomy with Delta-Shaped Anastomosis (RALG-d) with totally Laparoscopic Distal Gastrectomy with the Same Anastomosis (LAG-d) by a Propensity Score Matching (PSM). Methods: From March 2012 to April 2019, 31 patients underwent RALG-d, and 468 patients underwent LAG-d for gastric cancer by a single surgeon. Surgical outcomes were compared by PSM. Results: After PSM, 30 patients were included into the RALG-d group, and 118 patients into the LAG-d group. All of the covariates were balanced, except TNM stage. Mean operation times were longer in the RALG-d group than the LAG-d group (P<0.001). The number of retrieved lymph nodes and length of hospital stay were not significantly different (P=0.110 and P=0.939, respectively). The flatus passage was faster in the RALG-d group (P=0.002). The Numeric Rating Scale for pain (NRS) on postoperative day 3 in the RALG-d group was higher than that of the LAG-d group (P=0.051), while those on postoperative days 1 and 5 were similar between the two groups. Overall, postoperative complications were experienced by 1 patient (3.2%) in the RALG-d group and 28 (6.0%) in the LAG-d group (P=0.811). There was no operation-related mortality and no open conversion in both groups. Conclusion: Our study shows comparable surgical outcomes of RALG-d, especially rapid recovery of intestinal function. RALG-d can be a safe and feasible treatment option for gastric cancer.

Keywords

Gastric cancer; Robot-assisted gastrectomy; Delta-shaped anastomosis; Propensity score matching

Cite the article

Baek SY, Ko CS, Kim A, Kim BS, Lee IS. Robot-Assisted versus Totally Laparoscopic Distal Gastrectomy for Gastric Cancer: A Retrospective Propensity Score-Matched Analysis. Clin Surg. 2020; 5: 2764..