Comparison of Surgical Outcomes of Robot-Assisted and Laparoscopy-Assisted Pylorus-Preserving Gastrectomy for Gastric Cancer: A Propensity Score Matching Analysis

• Published in: Annals of surgical oncology Vol. 22; no. 7; pp. 2323 - 2328
• Main Authors: Han, Dong-Seok, Suh, Yun-Suhk, Ahn, Hye Seong, Kong, Seong-Ho, Lee, Hyuk-Joon, Kim, Woo-Ho, Yang, Han-Kwang
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2015; Springer Nature B.V
• Subjects: Body Mass Index; Comorbidity; Female; Follow-Up Studies; Gastrectomy; Gastrointestinal Oncology; Humans; Laparoscopy; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Oncology; Operative Time; Organ Sparing Treatments; Postoperative Complications; Prognosis; Propensity Score; Pylorus; Retrospective Studies; Robotics; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgery; Surgical Oncology; Gastric Cancer; Early Gastric Cancer; Propensity Score; Propensity Score Match; Left Gastric Artery
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-014-4204-6

Background The three-dimensional view and articulating devices in robot system might have a benefit performing the delicate procedure of pylorus-preserving gastrectomy. This study was conducted to evaluate the feasibility and safety of robot-assisted pylorus-preserving gastrectomy (RAPPG) and to compare the perioperative outcomes and oncologic safety between RAPPG and laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) for middle-third early gastric cancer. Methods Between June 2008 and December 2013, we retrospectively collected data of 68 patients with RAPPG and propensity score matched 68 patients with LAPPG for the treatment of early gastric cancer at Seoul National University Hospital. The covariates for propensity score matching were: age, sex, American Society of Anesthesiologists score, body mass index, and operators. Clinicopathologic characteristics and surgical outcomes were compared between the two groups. Results All RAPPG cases were performed successfully without open or laparoscopic conversion. Patient demographics and perioperative outcomes did not differ between the two groups except in operation time (258.3 vs. 193.9 min; P  < 0.001). There was no significant difference in complication rates between the two groups (19.1 vs. 22.1 %; P  = 0.671). The mean number of examined lymph nodes (33.4 vs. 36.5; P  = 0.153), and the mean number of lymph nodes at each station was not different between the two groups. Conclusions RAPPG can be a safe treatment option for middle-third early gastric cancer in terms of surgical complications and oncologic outcomes. However, RAPPG has no benefit over LAPPG in this study.