Long-term oncological outcomes in robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: a meta-analysis

2017 ◽  
Vol 31 (10) ◽  
pp. 4244-4251 ◽  
Author(s):  
Jing-hua Pan ◽  
Hong Zhou ◽  
Xiao-xu Zhao ◽  
Hui Ding ◽  
Li Qin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Laparoscopic Gastrectomy ◽  
Meta Analysis ◽  
Robotic Gastrectomy ◽  
Oncological Outcomes

scholarly journals Comparison of Long-Term and Perioperative Outcomes of Robotic Versus Conventional Laparoscopic Gastrectomy for Gastric Cancer: A Systematic Review and Meta-Analysis of PSM and RCT Studies

2021 ◽  
Vol 11 ◽  
Author(s):  
Qingbo Feng ◽  
Hexing Ma ◽  
Jie Qiu ◽  
Yan Du ◽  
Guodong Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Laparoscopic Gastrectomy ◽  
Resection Margin ◽  
Meta Analysis ◽  
Perioperative Outcomes ◽  
Controlled Study ◽  
Cochrane Central Register ◽  
Oncological Outcomes

BackgroundTo investigate the perioperative and oncological outcomes of gastric cancer (GC) after robotic versus laparoscopic gastrectomy (RG versus LG), we carried out a meta-analysis of propensity score matching (PSM) studies and randomized controlled study (RCT) to compare the safety and overall effect of RG to LG for patients with GC.MethodsPubMed, Web of Science, EMBASE, and Cochrane Central Register were searched based on a defined search strategy to identify eligible PSM and RCT studies before July 2021. Data on perioperative and oncological outcomes were subjected to meta-analysis.ResultsOverall, we identified 19 PSM studies and 1 RCT of RG versus LG, enrolling a total of 13,446 patients (6,173 and 7,273 patients underwent RG and LG, respectively). The present meta-analysis revealed nonsignificant differences in tumor size, proximal resection margin distance, distal resection margin distance, abdominal bleeding, ileus, anastomosis site leakage, duodenal stump leakage rate, conversion rate, reoperation, overall survival rate, and long-term recurrence-free survival rate between the two groups. Alternatively, comparing RG with LG, RG has a longer operative time (p < 0.00001), less blood loss (p <0.0001), earlier time to first flatus (p = 0.0003), earlier time to oral intake (p = 0.0001), shorter length of stay (p = 0.0001), less major complications (p = 0.0001), lower overall complications (p = 0.0003), more retrieved lymph nodes (P < 0.0001), and more cost (p < 0.00001).ConclusionsIn terms of oncological adequacy and safety, RG is a feasible and effective treatment strategy for gastric cancer but takes more cost in comparison with LG.

scholarly journals Robotic versus laparoscopic gastrectomy for gastric cancer: a systematic review and meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jianglei Ma ◽  
Xiaoyao Li ◽  
Shifu Zhao ◽  
Ruifu Zhang ◽  
Dejun Yang
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Robotic Surgery ◽  
Laparoscopic Gastrectomy ◽  
Resection Margin ◽  
Meta Analysis ◽  
Long Term Outcomes ◽  
Short Term ◽  
Meta Analyses

Abstract Background To date, robotic surgery has been widely used worldwide. We conducted a systematic review and meta-analysis to evaluate short-term and long-term outcomes of robotic gastrectomy (RG) in gastric cancer patients to determine whether RG can replace laparoscopic gastrectomy (LG). Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was applied to perform the study. Pubmed, Cochrane Library, WanFang, China National Knowledge Infrastructure (CNKI), and VIP databases were comprehensively searched for studies published before May 2020 that compared RG with LG. Next, two independent reviewers conducted literature screening and data extraction. The quality of the literature was assessed using the Newcastle-Ottawa Scale (NOS), and the data analyzed using the Review Manager 5.3 software. Random effects or fixed effects models were applied according to heterogeneity. Results A total of 19 studies including 7275 patients were included in the meta-analyses, of which 4598 patients were in the LG group and 2677 in the RG group. Compared with LG, RG was associated with longer operative time (WMD = −32.96, 95% CI −42.08 ~ −23.84, P < 0.001), less blood loss (WMD = 28.66, 95% CI 18.59 ~ 38.73, P < 0.001), and shorter time to first flatus (WMD = 0.16 95% CI 0.06 ~ 0.27, P = 0.003). There was no significant difference between RG and LG in terms of the hospital stay (WMD = 0.23, 95% CI −0.53 ~ 0.98, P = 0.560), overall postoperative complication (OR = 1.07, 95% CI 0.91 ~ 1.25, P = 0.430), mortality (OR = 0.67, 95% CI 0.24 ~ 1.90, P = 0.450), the number of harvested lymph nodes (WMD = −0.96, 95% CI −2.12 ~ 0.20, P = 0.100), proximal resection margin (WMD = −0.10, 95% CI −0.29 ~ 0.09, P = 0.300), and distal resection margin (WMD = 0.15, 95% CI −0.21 ~ 0.52, P = 0.410). No significant differences were found between the two treatments in overall survival (OS) (HR = 0.95, 95% CI 0.76 ~ 1.18, P = 0.640), recurrence-free survival (RFS) (HR = 0.91, 95% CI 0.69 ~ 1.21, P = 0.530), and recurrence rate (OR = 0.90, 95% CI 0.67 ~ 1.21, P = 0.500). Conclusions The results of this study suggested that RG is as acceptable as LG in terms of short-term and long-term outcomes. RG can be performed as effectively and safely as LG. Moreover, more randomized controlled trials comparing the two techniques with rigorous study designs are still essential to evaluate the value of the robotic surgery for gastric cancer.

Safety, effectiveness, and rapid adaptation of robotic gastrectomy for advanced gastric cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 161-161
Author(s):  
Lin Chen ◽  
Jiyang Li ◽  
Hongqing Xi ◽  
Yunhe Gao ◽  
Jianxin Cui ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Laparoscopic Gastrectomy ◽  
Open Gastrectomy ◽  
Robotic Gastrectomy ◽  
Long Term Outcomes ◽  
Short Term ◽  
Clinicopathologic Characteristics ◽  
Safety Effectiveness

161 Background: As robotic surgery techniques advances, robotic gastrectomy has emerged as an alternative modality for advanced gastric cancer (AGC). However, there is a lack of supporting evidence regarding the safety, effectiveness and surgeon acceptance of robotic gastrectomy for AGC patients. Methods: An ambispective cohort study was conducted. We compared surgical and oncological outcomes between robotic and traditional laparoscopic gastrectomy for AGC patients. The Cumulative Sum (CUSUM) method was developed and used to analyze the learning curves of robotic gastrectomy for AGC by two surgeons who had different surgical experience. Results: From August 2011 to June 2017, a total of 134 AGC patients were performed robotic gastrectomy by surgeon A (n = 42) and surgeon B (n = 147). And there were 238 AGC patients received traditional laparoscopic gastrectomy which performed by the same two surgeons over the same period. There were no significant differences between the two operation methods regarding the clinicopathologic characteristics and long-term outcomes (p=0.737). However, robotic gastrectomy group had less operative blood loss (229 ml vs. 240 ml, p=0.031) and less Clavien-Dindo Grade II to IV complications (p=0.006) than laparoscopic group. Clinicopathologic characteristics, short-term and long-term outcomes of the patients treated by surgeon A and surgeon B are similarity. CUSUM analysis showed that operative time reached a stable state after around 12 cases in surgeon A who had more open gastrectomy experience than laparoscopic gastrectomy experience, and 21 cases in surgeon B who had more laparoscopic gastrectomy experience than open gastrectomy experience. The stable operation time was 242 min for surgeon A and 236 min for surgeon B. The number of lymph node dissections was 38 for surgeon A and 28 for surgeon B during their capacity-increasing phase. Conclusions: Robotic gastrectomy achieved superior short-term outcomes and comparable long-term outcomes compared with traditional laparoscopic gastrectomy for AGC patients. Surgeons with sufficient experience in either open or laparoscopic gastrectomy can rapidly overcome the learning curve and performed gastrectomy for AGC patients safely.

scholarly journals Long-term oncological outcomes of laparoscopic gastrectomy for grossly early gastric cancer-mimicking advanced gastric cancer

Medicine ◽  
2020 ◽  
Vol 99 (49) ◽  
pp. e23441
Author(s):  
Sung Eun Oh ◽  
Ji Yeong An ◽  
Min-Gew Choi ◽  
Tae Sung Sohn ◽  
Jae Moon Bae ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Laparoscopic Gastrectomy ◽  
Oncological Outcomes

scholarly journals Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Jianglei Ma ◽  
Xiaoyao Li ◽  
Shifu Zhao ◽  
Ruifu Zhang ◽  
Dejun Yang
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Robotic Surgery ◽  
Laparoscopic Gastrectomy ◽  
Resection Margin ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Long Term Outcomes ◽  
Significant Difference

Abstract Background To date, robotic surgery has been widely used worldwide. We conducted a systematic review and meta-analysis to evaluate short- and long-term outcomes of robotic gastrectomy (RG) in gastric cancer patients to determine whether RG can replace laparoscopic gastrectomy (LG).Methods Pubmed, Cochrane Library, WanFang, China National Knowledge Infrastructure (CNKI) and VIP databases were comprehensively searched for studies published before May 2020 that compared RG with LG. Next, two independent reviewers conducted literature screening and data extraction. The quality of the literature was assessed using the Newcastle-Ottawa Scale (NOS),and the data analyzed using the Review Manager 5.3 software. Random effects or fixed effects models were applied according to heterogeneity.Results A total of 19 studies including 7275 patients were included in the meta-analyses, of which 4598 patients were in the LG group and 2677 in the RG group. Compared with LG,RG was associated with longer operative time (WMD=−32.96 min; 95% CI:-42.08~-23.84, P<0.00001),less blood loss (WMD=28.66 ml; 95% CI: 18.59~38.73, P<0.00001),and shorter time to first flatus (WMD=0.16days; 95%CI:0.06~0.27, P=0.003).There was no significant difference between RG and LG in terms of the hospital stay (WMD=0.23days, 95 % CI:-0.53~0.98, P=0.56),overall postoperative complication (OR=1.07, 95 % CI:0.91~1.25, P=0.43),mortality (OR=0.67, 95% CI=0.24~1.90, P=0.45),the number of harvested lymph nodes (WMD=-0.96, 95% CI:-2.12~0.20, P=0.10),proximal resection margin (WMD=-0.10 cm,95% CI:-0.29~0.09, P=0.30),and distal resection margin (WMD=0.15cm,95% CI:-0.21~0.52, P=0.41).No significant differences were found between the two treatments in overall survival(OS) (HR=0.95, 95% CI:0.76~1.18; P=0.64), recurrence-free survival(RFS) (HR=0.91, 95% CI:0.69~1.21;P=0.53), and recurrence rate (OR=0.90, 95% CI:0.67~1.21; P=0.50). Conclusions The results of this study suggested that RG is as acceptable as LG in terms of short-term and long-term outcomes. RG can be performed as effectively and safely as LG. Moreover, more randomized controlled trials comparing the two techniques with rigorous study designs are still essential to evaluate the value of the robotic surgery for gastric cancer.

Long-term oncologic outcomes of robotic gastrectomy for gastric cancer compared with laparoscopic gastrectomy.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 8-8
Author(s):  
Woo Jin Hyung ◽  
Kazutaka Obama ◽  
Yu Min Kim ◽  
Yanghee Woo ◽  
Kyung Ho Pak ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Laparoscopic Gastrectomy ◽  
Oncologic Outcome ◽  
Postoperative Recurrence ◽  
Oncologic Outcomes ◽  
Robotic Gastrectomy ◽  
Operative Outcomes ◽  
Significant Difference

8 Background: Although robotic gastrectomy (RG) showed satisfactory early postoperative outcomes, the oncologic safety of RG for gastric cancer remains a concern. We aimed to evaluate the oncologic safety of RG by comparing its long term outcomes with that of laparoscopic gastrectomy (LG). Methods: From July 2005 to December 2009, we performed 313 RGs and 524 LGs to the patients with gastric cancer. We retrospectively analyzed the patients’ characteristics, operative outcomes, overall survival (OS) and relapse-free survival (RFS), then compared between RG and LG groups using a prospectively maintained database. Results: With a median follow-up of 46 (1-80) months, there was no difference in the OS (log-rank p=0.625) nor in the RFS (p=0.761) between the two groups. When we compared the two groups stage by stage, the OS and RFS also did not differ significantly. Postoperative recurrence was observed in 17 patients (5.4%) in RG and 18 (3.4%) in LG, which showed no significant difference (p=0.745). The pattern of recurrence in RG showed 5 peritoneal, 5 loco-regional, 3 hematogenous,3 distant lymph node, and 1 mixed one. The recurence pattern of the two groups did not differ significantly. Conclusions: These data suggest that robotic assistance in gastrectomy for gastric cancer is acceptable because the oncologic outcome of RG was comparable to conventional LG in our experience.

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