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Robotic gastrectomy as an oncologically sound alternative to laparoscopic resections for the treatment of early-stage gastric cancers.

Authors
 Yanghee Woo  ;  Woo Jin Hyung  ;  Kyung-Ho Pak  ;  Kazuki Inaba  ;  Kazutaka Obama  ;  Seung Ho Choi  ;  Sung Hoon Noh 
Citation
 ARCHIVES OF SURGERY , Vol.146(9) : 1086-1092, 2011 
Journal Title
ARCHIVES OF SURGERY
ISSN
 0004-0010 
Issue Date
2011
MeSH
Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical ; Comorbidity ; Female ; Gastrectomy/methods* ; Humans ; Laparoscopy/methods* ; Length of Stay ; Lymph Node Excision ; Male ; Middle Aged ; Quality of Life ; Retrospective Studies ; Robotics* ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/surgery* ; Treatment Outcome
Keywords
Gastrectomy ; Laparoscopy ; Outcome Assessment (Health Care) ; Patient Safety ; Risk Assessment ; Robotics ; Stomach Neoplasms ; Surgical Procedures ; Minimally Invasive
Abstract
OBJECTIVE: To evaluate the comparative safety and efficacy of robotic vs laparoscopic gastrectomy for early-stage gastric cancer.

DESIGN: Retrospective analysis.

SETTING: Tertiary hospital.

PATIENTS: Eight hundred twenty-seven patients with gastric cancer.

INTERVENTIONS: Between July 2005 and April 2009, 827 patients with gastric cancer underwent 236 robotic and 591 laparoscopic radical gastrectomies with curative intent. The patients' data were prospectively collected and retrospectively analyzed.

MAIN OUTCOME MEASURES: We performed a comparative analysis between the robotic surgery group and laparoscopic surgery group for preoperative patient characteristics, intraoperative factors, and postoperative morbidity and mortality.

RESULTS: The robotic group was younger than the laparoscopic group, but other preoperative patient characteristics did not differ. The mean operative time for the robotic group (219.5 minutes) was on average 49 minutes longer than the laparoscopic group (170.7 minutes) (P < .001), while mean blood loss was significantly less in the robotic group (91.6 mL vs 147.9 mL; P = .002). The robotic group had mortality of 0.4% and morbidity of 11.0%, comparable with those of the laparoscopic group (P > .05). The number of lymph nodes retrieved per level was adequate in both groups and did not differ significantly. Robotic D1+α (n = 5), D1+β (n = 126), and D2 (n = 105) dissections retrieved 27.2, 36.7, and 42.4 mean numbers of lymph nodes, respectively. Except for 3 cases in the laparoscopic group, all specimens had negative margins.

CONCLUSIONS: Our largest comparative study demonstrates robotic gastrectomy to have better short-term and comparable oncologic outcomes compared with laparoscopic gastrectomy. A robotic approach to gastric cancer is a promising alternative to laparoscopic surgery.
Full Text
http://archsurg.jamanetwork.com/article.aspx?articleid=1107764
DOI
10.1001/archsurg.2011.114.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94062
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