A comparative study on Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer / 中华普通外科杂志

ABSTRACT

Objective To compare the short-term surgical outcomes of robotic-assisted gastrectomy versus laparoscopic-assisted procedures for gastric cancer patients.Method From 2014 to 2018,108 robotic procedures and 263 laparoscopic surgery were done at the Department of Gastrointestinal Surgery Affiliated Hospital of Qingdao University.Results Compared with the laparoscopic group,the robotic group had longer operation time [(269 ± 32) min vs.(205 ± 30) min,t =18.314,P ＜0.05],less intraoperative blood loss [(94 ± 52) ml vs.(130 ± 32) ml,t =-8.212,P ＜ 0.05],lower conversion rate (2.9％ vs.8.7％,x2=4.184,P＜ 0.05),more lymph node dissection [(45±11) vs.(41±10),t=3.502,P＜ 0.05],earlier exhaust time [(59 ±8) hvs.(61 ±9) h,t=-2.396,P＜ 0.05],higher total hospitalization cost [(75 763 ±2 981) yuan vs.(52 746 ± 3 904) yuan,t =55.024,P ＜ 0.05].There were no significant differences in hospital stay [(6.6 ±0.9) d vs.(6.5 ± 1.1) d,t =0.618,P ＞0.05],the proximal margin [(5.7 ± 1.1) cm vs.(5.4 ± 1.2) cm,t =1.583,P ＞ 0.05] and distal tumor margin [(4.7 ± 2.1) cm vs.(4.9 ± 2.0) cm,t =0.848,P ＞ 0.05].There were no significant differences in the incidence of complications (13.9％ vs.15.2％,x2 =0.106,P ＞0.05)and grade by Clavien-Dindo operation complications (Z =-0.271,P ＞ 0.05) between the two groups.Conclusion Da Vinci robotic radical gastrectomy is safe,better than laparoscopic procedure in intraoperative manipulation.