Comparison of short-term and long-term outcomes of robotic versus laparoscopic gastrectomy for locally advanced gastric cancer after neoadjuvant therapy
10.3760/cma.j.cn113855-20250523-00290
- VernacularTitle:局部进展期胃癌新辅助化疗后行机器人和腹腔镜胃癌根治术的近期与远期疗效对比
- Author:
Gan LIU
1
;
Qi LIU
1
;
Yulong TIAN
1
;
Shougen CAO
1
;
Xiaodong LIU
1
;
Zequn LI
1
;
Xiaojie TAN
1
;
Cheng MENG
1
;
Yuqi SUN
1
;
Yanbing ZHOU
1
Author Information
1. 青岛大学附属医院胃肠外科，青岛 266071
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Robot;
Gastrectomy;
Chemotherapy,adjuvant;
Laparoscopy
- From:
Chinese Journal of General Surgery
2025;40(8):607-612
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the short- and long-term outcomes of robotic versus laparoscopic gastrectomy in patients with locally advanced gastric cancer after neoadjuvant chemotherapy.Methods:Data from 321 patients with locally advanced gastric cancer undergoing neoadjuvant chemotherapy followed by robotic ( n=109) and laparoscopic ( n=212) radical gastrectomy at our center between May 2017 and Sep 2022 was collected. After 1∶1 propensity score matching, 106 patients from each group were included in the final analysis to compare short-term clinical outcomes and long-term prognostic indicators. Results:The robotic group had a significantly lower overall complication rate (13.2% vs. 28.3%, χ2=6.453, P=0.007) and surgery-related complication rate (8.5% vs. 17.9%, χ2=3.333, P=0.043) than the laparoscopic group. The robotic group also retrieved more total lymph nodes (35.3±4.9 vs. 31.4±6.3, t=4.863, P<0.001) and supra-pancreatic lymph nodes (13.1±3.4 vs. 10.1±2.1, t=5.258, P<0.001). Additionally, the robotic group had a shorter operative time [(218±47) min vs. (267±71) min, t=-6.001, P<0.001], less intraoperative blood loss [(47±12) ml vs. (71±17) ml, t=-5.424, P<0.001], and faster postoperative recovery. The 3-year recurrence-free survival rate was significantly higher in the robotic group compared to the laparoscopic group (75.5% vs. 62.3%, P=0.017). Conclusion:Compared with laparoscopic gastrectomy, robotic gastrectomy allows for a more lymph nodes harvest, significantly reduces intraoperative blood loss and complication rates and significantly improves recurrence-free survival.
