Robot Versus Laparoscopic Gastrectomy for Cancer by an Experienced Surgeon: Comparisons of Surgery, Complications, and Surgical Stress |
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Authors: | Myung-Han Hyun Chung-Ho Lee BSc Ye-Ji Kwon BSc Sung-Il Cho MD You-Jin Jang MD PhD Dong-Hoon Kim MD PhD Jong-Han Kim MD PhD Seong-Heum Park MD PhD Young-Jae Mok MD PhD Sung-Soo Park MD PhD |
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Affiliation: | 1. Division of Upper Gastrointestinal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul, 136-705, Korea 2. Department of Pharmacology, Korea University College of Medicine, Seoul, Korea
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Abstract: | 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. |
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