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Robotic versus open approach in total gastrectomy for gastric cancer: a comparative single-center study of perioperative outcomes

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Abstract

The robotic approach to gastric cancer has been gaining interest in recent years; however, its benefit over the open procedure in total gastrectomy with D2 lymphadenectomy is still controversial. The aims of the study were to compare postoperative morbidity and mortality, hospital stay, and anatomopathological findings between the robotic and open approaches to oncologic total gastrectomy. We analyzed a prospectively collected database, which included patients who underwent total gastrectomy with D2 lymphadenectomy in our center using a robotic or an open approach between 2014 and 2021. Comparative analysis of clinicopathological, intraoperative, postoperative and anatomopathological variables between the robot-assisted group and the open group was performed. Thirty patients underwent total gastrectomy with D2 lymphadenectomy by a robotic approach and 48 patients by an open procedure. Both groups were comparable. The robot-assisted group presented a lower rate of Clavien-Dindo complications ≥ stage II (20 vs. 48%, p = 0.048), a shorter hospital stay (7 days vs. 9 days, p = 0.003) and had a higher total number of lymph nodes resected (22 nodes vs. 15 nodes, p = 0.001) compared to the open approach. Operative time was longer in the robotic group (325 min vs. 195 min, p < 0.001) compared to the open group. The robotic approach is associated with a longer surgical time, a lower rate of Clavien-Dindo complications ≥ stage II and a shorter hospital stay, and more lymph nodes were resected compared to the open approach.

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Funding

The present study has not received specific support from public sector agencies, the commercial sector, or non-profit entities.

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Authors and Affiliations

  1. General Surgery Department, IRBLleida-University Hospital Arnau de Vilanova, Avda Alcalde Rovira Roure 80, 25198, Lérida, Spain

    Helena Salvador-Rosés, Alfredo Escartín, Pablo Muriel, Maite Santamaría, Marta González, Jimy Jara, Fulthon Vela & Jorge-Juan Olsina

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  1. Helena Salvador-Rosés
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  2. Alfredo Escartín
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  3. Pablo Muriel
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  4. Maite Santamaría
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  8. Jorge-Juan Olsina
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by AE, MS, MG, PM, JJ, J-JO and HS-R. Analysis was performed by FV and HS-R. The first draft of the manuscript was written by HS-R and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Helena Salvador-Rosés.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University Hospital Arnau de Vilanova.

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Informed consent was obtained from all individual participants included in the study.

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Salvador-Rosés, H., Escartín, A., Muriel, P. et al. Robotic versus open approach in total gastrectomy for gastric cancer: a comparative single-center study of perioperative outcomes. J Robotic Surg 17, 1735–1741 (2023). https://doi.org/10.1007/s11701-023-01591-1

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