Short-term outcomes of laparoscopic and robotic distal gastrectomy for gastric cancer: Real-world evidence from a large-scale inpatient database in Japan

J Surg Oncol. 2024 Apr;129(5):922-929. doi: 10.1002/jso.27575. Epub 2024 Jan 4.

Abstract

Background and objectives: Robotic distal gastrectomy (RDG) has been widely performed throughout Japan since it became insured in 2018. This study aimed to evaluate the short-term outcomes of RDG and laparoscopic distal gastrectomy (LDG) for gastric cancer using real-world data.

Methods: A total of 4161 patients who underwent LDG (n = 3173) or RDG (n = 988) for gastric cancer between April 2018 and October 2022 were identified through the Japanese Diagnosis Procedure Combination Database, which covers 42 national university hospitals. The primary outcome was postoperative in-hospital mortality rate. The secondary outcomes were postoperative complication rates, time to diet resumption, and postoperative length of stay (LOS).

Results: In-hospital mortality and postoperative complication rates in the RDG group were comparable with those in the LDG group (0.1% vs. 0.0%, p = 1.000, and 8.7% vs. 8.2%, p = 0.693, respectively). RDG was associated with a longer duration of anesthesia (325 vs. 262 min, p < 0.001), similar time to diet resumption (3 vs. 3 days, p < 0.001), and shorter postoperative LOS (10 vs. 11 days, p < 0.001) compared with LDG.

Conclusions: RDG was performed safely and provided shorter postoperative LOS, since it became covered by insurance in Japan.

Keywords: gastrectomy; gastroenterostomy; inpatients; laparoscopy; robotic surgical procedures; stomach neoplasms.

MeSH terms

  • Gastrectomy / methods
  • Humans
  • Inpatients
  • Japan / epidemiology
  • Laparoscopy* / methods
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Stomach Neoplasms*
  • Treatment Outcome