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Robotic gastrectomy for elderly gastric cancer patients: comparisons with robotic gastrectomy in younger patients and laparoscopic gastrectomy in the elderly

Authors
 Naoki Okumura  ;  Taeil Son  ;  Yoo Min Kim  ;  Hyoung-Il Kim  ;  Ji Yeong An  ;  Sung Hoon Noh  ;  Woo Jin Hyung 
Citation
 GASTRIC CANCER, Vol.19(4) : 1125-1134, 2016 
Journal Title
 GASTRIC CANCER 
ISSN
 1436-3291 
Issue Date
2016
MeSH
Aged ; Comorbidity ; Feasibility Studies ; Female ; Follow-Up Studies ; Gastrectomy/methods* ; Humans ; Laparoscopy/methods* ; Length of Stay ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Complications* ; Prognosis ; Prospective Studies ; Retrospective Studies ; Robotic Surgical Procedures/methods* ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Survival Rate
Keywords
Elderly ; Gastrectomy ; Laparoscopy ; Minimally invasive surgery ; Robot
Abstract
BACKGROUND: Robotic surgery for gastric cancer has been adopted to overcome technical difficulties in performing laparoscopic gastrectomy. This study aimed to investigate the feasibility and safety of robotic gastrectomy in elderly gastric cancer patients. METHODS: Patients who underwent laparoscopic or robotic gastrectomy from 2003 to 2010 in a single high-volume center were included in this study. We retrospectively compared preoperative characteristics, perioperative factors, and oncological parameters among an elderly (≥70 years old) robotic gastrectomy group (n = 49), a younger (<70 years old) robotic gastrectomy group (n = 321), and an elderly laparoscopic gastrectomy group (n = 132). RESULTS: The elderly robotic group presented with more comorbidities than the younger robotic group. Except for number of retrieved lymph nodes (36.5 vs. 41.5; P = 0.007), short-term operative outcomes including complications and pathological parameters were comparable between the two robotic groups. The elderly robotic group showed comparable disease-specific survival to the younger robotic group although overall survival was worse. Compared to their laparoscopic counterparts, the elderly robotic group showed longer mean operation time (227 vs. 174 min). Nevertheless, the incidence and severity of postoperative complications was not different between the two elderly groups. Overall and disease-specific survival were also comparable between the elderly groups. In multivariate analysis, age and surgical approach were not risk factors for overall and major complications. CONCLUSIONS: The outcomes of robotic gastrectomy in the elderly did not differ from those in younger robotic gastrectomy patients and were comparable to those in elderly patients who underwent laparoscopic gastrectomy. Thus, robotic gastrectomy could be a safe and feasible approach in elderly patients.
Full Text
https://link.springer.com/article/10.1007%2Fs10120-015-0560-6
DOI
10.1007/s10120-015-0560-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Son, Tae Il(손태일) ORCID logo https://orcid.org/0000-0002-0327-5224
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152289
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