TY - JOUR
T1 - Robot versus laparoscopic gastrectomy for cancer by an experienced surgeon
T2 - Comparisons of surgery, complications, and surgical stress
AU - Hyun, Myung Han
AU - Lee, Chung Ho
AU - Kwon, Ye Ji
AU - Cho, Sung Il
AU - Jang, You Jin
AU - Kim, Dong Hoon
AU - Kim, Jong Han
AU - Park, Seong Heum
AU - Mok, Young Jae
AU - Park, Sung Soo
N1 - Funding Information:
ACKNOWLEDGMENT We would like to thank Dr. Hye-Young Cho for her collection and management of the data for the study population. This study was supported by a grant from the National R&D program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1020410).
PY - 2013/4
Y1 - 2013/4
N2 - Background: No previous robotic studies present an equivalent surgical quality comparison in an experienced setting for gastric cancer. In addition, a reliable postoperative complication assessment is needed to accurately evaluate surgical outcomes. Methods: After 20 cases of robotic-assisted gastrectomy (RAG), a total of 121 consecutive gastric cancer patients underwent gastrectomy (38 RAG vs 83 laparoscopic-assisted gastrectomy [LAG]) from February 2009 to November 2010 at the Department of Surgery, Korea University Anam Hospital, Seoul, Korea. The Clavien-Dindo (C-D) classification was used to classify surgical complications. The granulocyte-to-lymphocyte (G:L) ratio was analyzed to evaluate surgical stress. Results: The baseline characteristics, with the exception of age, were similar. The mean total operation time for RAG (234.4 ± 48.0 min) was not significantly different than that for LAG (220.0 ± 60.6 min; P = 0.198). However, in obese patients, fewer lymph nodes were harvested by RAG (23.4 ± 7.0) than by LAG (32.2 ± 12.5, P = 0.006). Overall C-D complications were more common for RAG (47.3 vs 38.5 %), but the difference was not significant (P = 0.361). The mean hospital stay was similar for the 2 groups. Surgical stress as estimated by the G:L ratio was comparable between the 2 groups. Conclusions: RAG performed by an experienced surgeon resulted in similar postoperative outcomes and complications to those of LAG. Assessment of operation time, C-D complication grade, and G:L ratio revealed that RAG is a practical and feasible alternative to LAG, with the possible exception of obese patients.
AB - Background: No previous robotic studies present an equivalent surgical quality comparison in an experienced setting for gastric cancer. In addition, a reliable postoperative complication assessment is needed to accurately evaluate surgical outcomes. Methods: After 20 cases of robotic-assisted gastrectomy (RAG), a total of 121 consecutive gastric cancer patients underwent gastrectomy (38 RAG vs 83 laparoscopic-assisted gastrectomy [LAG]) from February 2009 to November 2010 at the Department of Surgery, Korea University Anam Hospital, Seoul, Korea. The Clavien-Dindo (C-D) classification was used to classify surgical complications. The granulocyte-to-lymphocyte (G:L) ratio was analyzed to evaluate surgical stress. Results: The baseline characteristics, with the exception of age, were similar. The mean total operation time for RAG (234.4 ± 48.0 min) was not significantly different than that for LAG (220.0 ± 60.6 min; P = 0.198). However, in obese patients, fewer lymph nodes were harvested by RAG (23.4 ± 7.0) than by LAG (32.2 ± 12.5, P = 0.006). Overall C-D complications were more common for RAG (47.3 vs 38.5 %), but the difference was not significant (P = 0.361). The mean hospital stay was similar for the 2 groups. Surgical stress as estimated by the G:L ratio was comparable between the 2 groups. Conclusions: RAG performed by an experienced surgeon resulted in similar postoperative outcomes and complications to those of LAG. Assessment of operation time, C-D complication grade, and G:L ratio revealed that RAG is a practical and feasible alternative to LAG, with the possible exception of obese patients.
UR - http://www.scopus.com/inward/record.url?scp=84875223859&partnerID=8YFLogxK
U2 - 10.1245/s10434-012-2679-6
DO - 10.1245/s10434-012-2679-6
M3 - Article
C2 - 23080320
AN - SCOPUS:84875223859
SN - 1068-9265
VL - 20
SP - 1258
EP - 1265
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 4
ER -