위암에서의 로봇위절제술: 수술 후 단기 성적 및 장기 종양학적 안정성 검토

Abstract

Robotic gastrectomy is a promising alternative to laparoscopic surgery for gastric cancer. This review examines the indications and the short-term surgical and long-term oncologic results of robotic gastrectomy. The indications for robotic gastrectomy have evolved in parallel to those for laparoscopic gastrectomy, with D1+ lymphadenectomy performed for early gastric cancer and D2 lymphadenectomy reserved for advanced gastric cancer. Regarding short-term outcomes, robotic gastrectomy is associated with less intraoperative blood loss, and longer operation times, compared with laparoscopic gastrectomy. Mortality and overall complication rates are similar between the two approaches, although robotic gastrectomy has been associated with lower rates of severe complications requiring surgical intervention or intensive care unit admission as well as infectious complications, such as anastomotic leakage, pancreatic fistula, and intraabdominal abscess. Long-term oncologic outcomes, including overall and disease-free survival and recurrence rates, were comparable between robotic and laparoscopic surgeries. Despite the associated high cost, the potential of robotic gastrectomy is expected to be realized with the recent introduction of various robotic surgical systems, which should aid in resolving cost concerns through market competition. Furthermore, the development of new evaluation tools that can objectively assess ergonomic benefits and surgeon fatigue should demonstrate the practical value of robotic surgery in the treatment of gastric cancer.