Comparison of short-term outcomes between robotic and laparoscopic gastrectomy for gastric cancer: a propensity score-matching analysis

J Robot Surg. 2021 Oct;15(5):803-811. doi: 10.1007/s11701-020-01182-4. Epub 2021 Jan 2.

Abstract

Robotic gastrectomy (RG) is increasingly performed based on expected benefits in short-term outcomes. However, it is still unclear if RG has any advantages over laparoscopic gastrectomy (LG). A retrospective cohort study was performed in patients who underwent minimally invasive gastrectomy between January 2012 and January 2020. A total of 366 patients were enrolled and short-term outcomes were compared between RG and LG. Propensity score matching was conducted to reduce selection bias based on age, sex, body mass index, performance status, physical status, clinical T, clinical N, clinical M, tumor location, neoadjuvant chemotherapy, type of gastrectomy, and extent of lymphadenectomy. A propensity score-matching algorithm was used to select 93 patients for each group. Estimated blood loss was smaller (0 vs. 37 mL, P = 0.001), length of hospital stay was shorter (10 vs. 12 days, P = 0.012), and the time until starting a soft diet was shorter (3 vs. 4 days, P = 0.001) in RG compared to LG. The overall complication rate was also lower in RG (9.7% vs 14.0%), but the difference was not significant. There was no mortality in either group. Total gastrectomy was an independent risk factor for postoperative complications. RG can be safely performed with a similar complication rate to that in LG and may permit faster postoperative recovery and a shorter hospital stay.

Keywords: Gastric cancer; Laparoscopic gastrectomy; Propensity score matching; Robotic gastrectomy.

MeSH terms

  • Gastrectomy
  • Humans
  • Laparoscopy*
  • Length of Stay
  • Postoperative Complications
  • Propensity Score
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Stomach Neoplasms* / surgery
  • Treatment Outcome