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Surgical Outcomes After Open, Laparoscopic, and Robotic Gastrectomy for Gastric Cancer

Authors
 Seung Yoon Yang  ;  Kun Ho Roh  ;  You-Na Kim  ;  Minah Cho  ;  Seung Hyun Lim  ;  Taeil Son  ;  Woo Jin Hyung  ;  Hyoung-Il Kim 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.24(7) : 1770-1777, 2017 
Journal Title
 ANNALS OF SURGICAL ONCOLOGY 
ISSN
 1068-9265 
Issue Date
2017
MeSH
Conversion to Open Surgery/methods* ; Female ; Follow-Up Studies ; Gastrectomy/methods* ; Humans ; Laparoscopy/methods* ; Male ; Middle Aged ; Postoperative Complications* ; Prospective Studies ; Retrospective Studies ; Robotic Surgical Procedures/methods* ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Treatment Outcome
Abstract
BACKGROUND: In contrast to the significant advantages of laparoscopic versus open gastrectomy, robotic gastrectomy has shown little benefit over laparoscopic gastrectomy. This study aimed to compare multi-dimensional aspects of surgical outcomes after open, laparoscopic, and robotic gastrectomy. METHODS: Data from 915 gastric cancer patients who underwent gastrectomy by one surgeon between March 2009 and May 2015 were retrospectively reviewed. Perioperative parameters were analyzed for short-term outcomes. Surgical success was defined as the absence of conversion to open surgery, major complications, readmission, positive resection margin, or fewer than 16 retrieved lymph nodes. RESULTS: This study investigated 241 patients undergoing open gastrectomy, 511 patients undergoing laparoscopic gastrectomy, and 173 patients undergoing robotic gastrectomy. For each approach, the respective incidences were as follows: conversion to open surgery (not applicable, 0.4%, and 0%; p = 0.444), in-hospital major complications (5.8, 2.7, and 1.2%; p = 0.020), delayed complications requiring readmission (2.9, 2.0, and 1.2%; p = 0.453), positive resection margin (1.7, 0, and 0%; p = 0.003), and inadequate number of retrieved lymph nodes (0.4, 4.1, and 1.7%; p = 0.010). Compared with open and laparoscopic surgery, robotic gastrectomy had the highest surgical success rate (90, 90.8, and 96.0%). Learning-curve analysis of success using cumulative sum plots showed success with the robotic approach from the start. Multivariate analyses identified age, sex, and gastrectomy extent as significant independent parameters affecting surgical success. Surgical approach was not a contributing factor. CONCLUSIONS: Open, laparoscopic, and robotic gastrectomy exhibited different incidences and causes of surgical failure. Robotic gastrectomy produced the best surgical outcomes, although the approach method itself was not an independent factor for success.
Full Text
https://link.springer.com/article/10.1245%2Fs10434-017-5851-1
DOI
10.1245/s10434-017-5851-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, You Na(김유나)
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Roh, Kun Ho(노건호)
Son, Tae Il(손태일) ORCID logo https://orcid.org/0000-0002-0327-5224
Yang, Seung Yoon(양승윤) ORCID logo https://orcid.org/0000-0001-8129-7712
Lim, Seung Hyun(임승현)
Cho, Minah(조민아) ORCID logo https://orcid.org/0000-0003-3011-5813
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160548
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