Robotic vs laparoscopic distal gastrectomy with D2 lymphadenectomy for gastric cancer: a retrospective comparative mono-institutional study

BMC Surgery

Research Article

Luca Messerini¹  Luca Novelli¹  Maria Novella Ringressi²  Fabio Cianchi²  Etleva Qirici²  Antonio Taddei²  Benedetta Badii²  Ileana Skalamera²  Fabio Staderini²  Giulia Fiorenza²  Giuliano Perigli²  Caterina Foppa²  Giampiero Indennitate³  Manuela Ortolani³  Beatrice Paoli³  Beatrice Mallardi⁴  Giuseppe Macrì⁵  Siro Bagnoli⁵  Giacomo Trallori⁵  Andrea Bonanomi⁵  Gabriele Lami⁵ 

[1] Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy;Department of Surgery and Translational Medicine, Center of Oncological Minimally Invasive Surgery (COMIS), University of Florence, Largo Brambilla 3, 50134 Florence, Italy;IFCA, Florence, Italy;ISPO, Florence, Italy;Unit of Gastroenterology, University Hospital Careggi, Florence, Italy;

关键词: Gastric cancer;    Robotic surgery;    Laparoscopy;    Lymphadenectomy;    Distal gastrectomy;   

DOI  :  10.1186/s12893-016-0180-z

 received in 2015-12-07, accepted in 2016-09-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundRobotic surgery has been developed with the aim of improving surgical quality and overcoming the limitations of conventional laparoscopy in the performance of complex mini-invasive procedures. The present study was designed to compare robotic and laparoscopic distal gastrectomy in the treatment of gastric cancer.MethodsBetween June 2008 and September 2015, 41 laparoscopic and 30 robotic distal gastrectomies were performed by a single surgeon at the same institution. Clinicopathological characteristics of the patients, surgical performance, postoperative morbidity/mortality and pathologic data were prospectively collected and compared between the laparoscopic and robotic groups by the Chi-square test and the Mann-Whitney test, as indicated.ResultsThere were no significant differences in patient characteristics between the two groups. Mean tumor size was larger in the laparoscopic than in the robotic patients (5.3 ± 0.5 cm and 3.0 ± 0.4 cm, respectively; P = 0.02). However, tumor stage distribution was similar between the two groups. The mean number of dissected lymph nodes was higher in the robotic than in the laparoscopic patients (39.1 ± 3.7 and 30.5 ± 2.0, respectively; P = 0.02). The mean operative time was 262.6 ± 8.6 min in the laparoscopic group and 312.6 ± 15.7 min in the robotic group (P < 0.001). The incidences of surgery-related and surgery-unrelated complications were similar in the laparoscopic and in the robotic patients. There were no significant differences in short-term clinical outcomes between the two groups.ConclusionsWithin the limitation of a small-sized, non-randomized analysis, our study confirms that robotic distal gastrectomy is a feasible and safe surgical procedure. When compared with conventional laparoscopy, robotic surgery shows evident benefits in the performance of lymphadenectomy with a higher number of retrieved and examined lymph nodes.

【 授权许可】

CC BY   
© The Author(s). 2016