Robotic gastrectomy versus laparoscopic gastrectomy in treatment of gastric cancer

Objective To compare the surgical outcome of robotic versus laparoscopic gastectomy in treatment of gastric cancer. Methods Clinical data about 515 patients with gastric cancer who underwent robotic gastrectomy (RG) or laparoscopic gastrectomy(LG) in our department from June 2012 to June 2017 were retrospectively analyzed. There were 381 males and 134 females with average age of 59.8 years old. Patients were classified into distal gastrectomy group (DG, n=267), proximal gastrectomy group (PG, n=116) and total gastrectomy group (TG, n=132). The operating time, estimated blood loss, retrieved lymph nodes, time to take liquid diet, postoperative hospital stay and complication were collected and compared in the three groups. Results In the three groups, RG showed less estimated blood lossDG:100 (50, 200) ml vs 100 (100, 200) ml, P=0.002; PG:100 (80, 200) ml vs 130 (100, 200) ml, P=0.020; TG:150 (100, 200) ml vs 200 (150, 325) ml, P=0.001 and longer operating timeDG:(222.8±42.9) min vs (189.6±37.1)min, P=0.000; PG:(222.4±39.4) min vs (195.5±32.4) min, P=0.000; TG:(248.3±41.8) min vs (226.0±47.0) min, P=0.001.There was no significant difference in complication rate, time to take liquid diet and postoperative hospital stay between two groups(all P> 0.05). The lymph nodes achieved by RG were more than that achieved by LG in distal gastrectomy group(25.3±8.7) vs(21.8±8.6), P=0.001. However, it was not significantly different in proximal gastrectomy group and total gastrectomy group (P> 0.05). Conclusion Compared with LG, RG shows less estimated blood loss but longer operating time. The lymph nodes harvested by RG are as many as those harvested by LG in proximal and total gastrectomy group while RG has a advantage of more retrieved lymph nodes in distal gastrectomy compared with LG. RG should be selectively used in distal gastrectomy.