Comparison of operative outcomes among laparoscopic, 3D-laparoscopic, and robotic gastrectomy for distal gastric cancer

Objective: Minimally invasive surgery has become popular in the treatment of gastric cancer Background: Few reports have compared operative outcomes among laparoscopic, 3D-laparoscopic and robotic gastrectomy for distal gastric cancer. Methods: Between August 2011 and June 2020, a total of 245 patients underwent either laparoscopic (n=129), 3D-laparoscopic (n=55) or robotic (n=61) gastrectomy for distal gastric cancer; the clinicopathologic characteristics and operative outcomes were compared between groups. Results: Compared with the laparoscopic group, the 3D-laparoscopic and robotic groups were associated with more D2 lymphadenectomy, higher medical costs and a longer operative time, while the number of retrieved lymph nodes and surgical complications were similar among the three groups. For patients receiving D2 lymphadenectomy, the robotic group was associated with higher medical costs and longer operative time than the other two groups; high-body mass index (high-BMI) patients had a longer operative time than low-BMI patients in the laparoscopic group, which was not significantly different between low- and high-BMI patients in both the 3D-laparoscopic and robotic groups. For low-BMI patients, the medical costs were higher and the operative time was longer in the robotic group than the other two groups. For high-BMI patients, the robotic group was associated with higher medical costs, longer operative time and postoperative hospital stay than the other two groups. Conclusions: 3D-laparoscopic gastrectomy was associated with affordable medical costs, comparable lymphadenectomy, and similar surgical outcomes compared with robotic gastrectomy.

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Phẫu thuật nội soi 3D cắt bán phần xa dạ dày trong điều trị ung thư dạ dày

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2021.74.3 ◽

2021 ◽

Author(s):

Hai Thanh Phan

Keyword(s):

Gastric Cancer ◽

Blood Loss ◽

Operative Time ◽

Distal Gastrectomy ◽

Three Dimensional ◽

Oncologic Outcome ◽

Intraoperative Blood Loss ◽

3D Laparoscopy ◽

Distal Gastric Cancer ◽

The Mean

TÓM TẮT Đặt vấn đề: Những nghiên cứu gần đây cho thấy phẫu thuật nội soi với kỹ thuật 3D (three - dimensional) đã mang lại nhiều thuận lợi trong điều trị ung thư dạ dày khi so sánh với màn hình 2D truyền thống. Vì vậy chúng tôi thực hiện nghiên cứu này với mục đích đánh giá tính an toàn, kết quả ngắn hạn và kết quả ung thư học của phẫu thuật nội soi 3D trong điều trị ung thư phần xa dạ dày. Phương pháp nghiên cứu: Thực hiện nghiên cứu tiến cứu trên 37 bệnh nhân cắt phần xa dạ dày kèm nạo vét hạch điều trị ung thư dạ dày bằng phẫu thuật nội soi kỹ thuật 3D tại Khoa Ngoại nhi - cấp cứu bụng, Bệnh viện Trung Ương Huế từ 03/2018 đến 09/2021. Kết quả: Phẫu thuật nội soi 3D được thực hiện ở tất cả 37 bệnh nhân, không có trường hợp nào chuyển mổ mở. Thời gian phẫu thuật trung bình là 69,86 ± 20,46 phút, lượng máu mất trong mổ trung bình là 171,22 ± 15,47 ml, số hạch vét được trung bình là 20,49 ± 4,11 hạch và thời gian nằm viện sau phẫu thuật trung bình là 10 ngày (6 - 26 ngày). Tỷ lệ biến chứng là 8,1 % với 1 trường hợp (2,7%) dò mỏm tá tràng, không có trường hợp nào tử vong sớm sau mổ. Tỉ lệ sống còn sau 1 năm là 87,27% và sau 3 năm là 83,31%. Kết luận: Áp dụng phẫu thuật nội soi 3D trong cắt phần xa dạ dày có thể thực hiện an toàn và khả thi. Giúp giảm đáng kể thời gian mổ, lượng máu mất trong mổ và đảm bảo được nguyên tắc an toàn về ung thư học. ABSTRACT EFFICACY USING THREE - DIMENSIONAL LAPAROSCOPY IN THE TREATMENT OF DISTAL GASTRIC CANCER Background: Recent studies have supported that three - dimensional (3D) laparoscopy has advantages in treating gastric cancer compared with conventional two - dimensional (2D) screens. This study investigated the safety, short - term efficacy, and oncological outcome of three - dimensional (3D) laparoscopic distal gastric cancer surgery. Materials and Methods: We prospectively analyzed the clinical data from 37 patients treated with 3D laparoscopic systemic lymphadenectomy for distal gastric cancer at the Hue Central Hospital from March 2018 to September 2021. The effects on operative time, intraoperative blood loss, the number of lymph nodes removed, postoperative recovery time, complications, and oncologic outcome were analyzed. Results: Three - dimensional (3D) laparoscopic distal gastrectomy was successfully carried out in 37 patients. The mean operative time was 69,86 ± 20,46 minutes, mean intraoperative blood loss was 171,22 ± 15,47 ml, the number of harvested lymph nodes was 20,49 ± 4,11, and the mean postoperative hospital stay was 10 (6 - 26 days). The incidence of postoperative complications was 8,1%, with 1 case of duodenal stump fistula. The one - year overall survival rate was 87,27%, and the three - year overall survival rate was 83,31%. Conclusions: 3D laparoscopy distal gastrectomy could be performed safely and feasibly. They reducethe operative time and intraoperative blood loss in distal gastrectomy with a good oncologic outcome. Keywords: Laparoscopic gastrectomy, D2 lymphadenectomy, 3D laparoscopy

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Similar Operative Outcomes between the da Vinci Xi® and da Vinci Si® Systems in Robotic Gastrectomy for Gastric Cancer

Journal of Gastric Cancer ◽

10.5230/jgc.2019.19.e13 ◽

2019 ◽

Vol 19 (2) ◽

pp. 165 ◽

Cited By ~ 4

Author(s):

Rana M. Alhossaini ◽

Abdulaziz A. Altamran ◽

Seohee Choi ◽

Chul-Kyu Roh ◽

Won Jun Seo ◽

...

Keyword(s):

Gastric Cancer ◽

Da Vinci ◽

Da Vinci Xi ◽

Robotic Gastrectomy ◽

Operative Outcomes ◽

Da Vinci Si

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A comparison between laparoscopic and robotic-assisted laparoscopic pyeloplasty in patients with ureteropelvic junction obstruction

10.21203/rs.3.rs-79979/v1 ◽

2020 ◽

Author(s):

Niwat Lukkanawong ◽

Masashi Honda ◽

Shogo Teraoka ◽

Yusuke Kimura ◽

Tetsuya Yumioka ◽

...

Keyword(s):

Robotic Surgery ◽

Operative Time ◽

Ureteropelvic Junction Obstruction ◽

Laparoscopic Group ◽

Ureteropelvic Junction ◽

Laparoscopic Pyeloplasty ◽

Robotic Group ◽

Robotic Assisted ◽

Drain Removal ◽

Significant Difference

Abstract Background The aim of this study is to compare the results of laparoscopic pyeloplasty and robotic-assisted laparoscopic pyeloplasty in patients with ureteropelvic junction obstruction. Methods Between March 2008 and May 2019, the patients who underwent retroperitoneal laparoscopic or robotic-assisted laparoscopic pyeloplasty in our institution were retrospectively reviewed. Results Thirteen patients underwent laparoscopically, and 12 patients underwent robotic surgery. The significant difference was found in median operative time between laparoscopic group (296 minutes) and robotic group (199 minutes) (P = 0.001). The median time for drain removal in laparoscopic group was longer than robotic group (3 vs 2 days, respectively, P = 0.029). Conclusions Laparoscopic and robotic-assisted laparoscopic pyeloplasty is safe and excellent success rates in patients with ureteropelvic junction obstruction. However, our experience study suggested that robotic surgery improves a total operative time, decreases drain removal time and less intraoperative blood loss than laparoscopic approach.

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Laparoscopic vs open gastrectomy- An updated metaanalysis of randomised control trials for short term outcomes

10.1101/2020.04.12.20062562 ◽

2020 ◽

Author(s):

Bhavin Vasavada ◽

Hardik Patel

Keyword(s):

Gastric Cancer ◽

Blood Loss ◽

Operative Time ◽

Laparoscopic Group ◽

Open Gastrectomy ◽

Systemic Review ◽

Wound Complications ◽

Short Term ◽

Significant Difference ◽

Randomised Control Trials

AbstractIntroductionAim of this metaanalysis was to compare short term outcomes of laparoscopic and open gastrectomy for gastric cancer.Material and methodsEMBASE, MEDLINE, PubMed and the Cochrane Database were searched for randomised control trials comparing outcomes in patients undergoing laparoscopic gastrectomies with those patients undergoing open gastrectomies. The primary outcome was 30 day morbidity and mortality. Secondary outcomes studied included length of stay, blood loss, d2gastrectomies, lymphnode retrieval, operative time, distal gastrectomy, wound complications and intraabdominal complications Systemic review and Metaanalysis were done according to MOOSE and PRISMA guidelines.ResultsMorbidity was significantly low in laparoscopic group(P=0.004).There was no significant difference between mortality between the two groups. (P=0.989). There less wound complications in laparoscpic group, no difference intra-abdominal complications in both the groups. Operative time was significantly higher in laparoscopic group. (P< 0.001) wmd 56.904. Hospital stay was similar in laparoscopic group. (P=0.305) wmd –0.533 days. Blood loss was significantly lesser in laparoscopic group.(p <0.001). Laparoscopic group patients had less number of lymph node retrieval compared to laparoscopic group.(p< 0.001). Laparoscopic group also contained similar advanced staged gastric cancer than open gastrectomies.ConclusionsLaparoscopic gastrectomies were associated with better short term outcomes.

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

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.4_suppl.8 ◽

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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Robotic versus laparoscopic inguinal hernia repair: an updated systematic review and meta-analysis

Journal of Robotic Surgery ◽

10.1007/s11701-021-01312-6 ◽

2021 ◽

Author(s):

Leonardo Solaini ◽

Davide Cavaliere ◽

Andrea Avanzolini ◽

Giuseppe Rocco ◽

Giorgio Ercolani

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Operative Time ◽

Meta Analysis ◽

Laparoscopic Group ◽

Robotic Approach ◽

Robotic Group ◽

Conversion To Open Surgery ◽

Safety Parameters

AbstractThe aim of this study was to review the latest evidence on the robotic approach (RHR) for inguinal hernia repair comparing the pooled outcome of this technique with those of the standard laparoscopic procedure (LHR). A systematic literature search was performed in PubMed, Web of Science and Scopus for studies published between 2010 and 2021 concerning the comparison between RHR versus LHR. After screening 582 articles, 9 articles with a total of 64,426 patients (7589 RHRs) were eligible for inclusion. Among preoperative variables, a pooled higher ratio of ASA > 2 patients was found in the robotic group (12.4 vs 8.6%, p < 0.001). Unilateral hernia repair was more common in the laparoscopic group (79.9 vs 68.1, p < 0.001). Overall, operative time was longer in the robotic group (160 vs 90 min, p < 0.001); this was confirmed also in the sub-analysis on unilateral procedures (88 vs 68 min, p = 0.040). The operative time for robotic bilateral repair was similar to the laparoscopic one (111 vs 100, p = 0.797). Conversion to open surgery was 0% in the robotic group. The pooled rate of chronic pain and postoperative complications was similar between the groups. The standardized mean difference MD of the costs between LHR versus RHR was − 3270$ (95% CI – 4757 to − 1782, p < 0.001). In conclusion, laparoscopic and robotic inguinal hernia repair have similar safety parameters and postoperative outcomes. Robotic approach may require longer operative time if the unilateral repair is performed. Costs are higher in the robotic group.

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Surgical outcomes and learning curve analysis of robotic gastrectomy for gastric cancer: multidimensional analysis in a comparison with 3D laparoscopic gastrectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.162 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 162-162

Author(s):

Lin Chen ◽

Jiyang Li ◽

Xin Guo ◽

Hongqing Xi ◽

Yunhe Gao ◽

...

Keyword(s):

Gastric Cancer ◽

Nasogastric Tube ◽

Laparoscopic Gastrectomy ◽

Surgical Outcomes ◽

Operative Time ◽

Multidimensional Analysis ◽

Robotic Gastrectomy ◽

Short Term ◽

Financial Cost ◽

3D Laparoscopic Gastrectomy

162 Background: There is a lack of supporting evidence regarding the safety, efficacy and surgeon acceptance of robotic versus three-dimensional (3D) laparoscopic surgery for patients with gastric cancer (GC). Methods: An ambispective cohort study was conducted. We compared short-term surgical outcomes including financial cost between robotic and 3D laparoscopic gastrectomy for all GC patients and the GC patients treated by Prof. Chen’s team. The Cumulative Sum (CUSUM) method was developed and used to analyze the learning curves of robotic and 3D laparoscopic gastrectomy performed by Prof. Chen. Results: From August 2011 to June 2017, a total of 517 patients were enrolled for treatment with either robotic (n=408 including n=73 performed by Prof. Chen) or 3D laparoscopic (n=109 including n=71 performed by Prof. Chen) gastrectomy. There were no significant differences between the two operation methods regarding the clinical pathological characteristics, except for smoking habit (p < 0.001). In analysis of all the 517 patients, robotic group had shorter operative time (208 min vs 228 min, p=0.004), less time to first flatus (3 days vs 4 days, p=0.025), longer time to remove drainage and nasogastric tube (12 days vs 9 days, p=0.001, 6 days vs. 4 days, p=0.001, respectively), and more postoperative complications (21.3% vs. 9.2%, p=0.003). While we compared these short-term outcomes of robotic and 3D laparoscopic gastrectomy performed by Prof. Chen, only number of lymph node dissections (robotic 27 vs. 3D 33, p=0.038) and time to remove nasogastric tube (robotic 5 days vs. 3D 3 days, p < 0.001) were significantly different. CUSUM analysis showed that operative time reached a stable state after around 21 cases in robotic gastrectomy and 19 cases in 3D laparoscopic gastrectomy. The cost-effectiveness analysis showed that robotic gastrectomy had significantly higher total cost than 3D laparoscopic gastrectomy (robotic = RMB 124907 vs. 3D-laparoscopic = RMB 94395; p < 0.001). Conclusions: With comparable surgical outcomes, higher surgeon acceptance and less financial cost, 3D laparoscope is a highly recommended minimal invasive surgical method for GC patients.

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