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Randomized Controlled Trial
. 2021 May 1;273(5):858-867.
doi: 10.1097/SLA.0000000000004466.

Assessment of Robotic Versus Laparoscopic Distal Gastrectomy for Gastric Cancer: A Randomized Controlled Trial

Jun Lu  1   2   3   4 , Chao-Hui Zheng  1   2   3   4 , Bin-Bin Xu  1   2   3   4 , Jian-Wei Xie  1   2   3   4 , Jia-Bin Wang  1   2   3   4 , Jian-Xian Lin  1   2   3   4 , Qi-Yue Chen  1   2   3   4 , Long-Long Cao  1   2   3   4 , Mi Lin  1   2   3   4 , Ru-Hong Tu  1   2   3   4 , Ze-Ning Huang  1   2   3   4 , Ju-Li Lin  1   2   3   4 , Hua-Long Zheng  1   2   3   4 , Chang-Ming Huang  1   2   3   4 , Ping Li  1   2   3   4
Affiliations
Randomized Controlled Trial

Assessment of Robotic Versus Laparoscopic Distal Gastrectomy for Gastric Cancer: A Randomized Controlled Trial

Jun Lu et al. Ann Surg. .

Abstract

Objective: To evaluate the short-term outcomes of patients with GC who received RDG or LDG.

Summary background data: Despite the increasing use of RDG in patients with GC, its safety and efficacy compared to those of LDG have not been elucidated in a randomized controlled trial.

Methods: Three hundred patients with cT1-4a and N0/+ between September 2017 and January 2020 were enrolled in this randomized controlled trial at a high-volume hospital in China. The short-term outcomes were compared between the groups.

Results: The modified intention-to-treat analysis included data from 283 patients (RDG group: n = 141) and (LDG group: n = 142). Patients in the RDG group exhibited faster postoperative recovery, milder inflammatory responses, and reduced postoperative morbidity (9.2% vs 17.6%, respectively, P = 0.039). Higher extraperigastric lymph nodes (LNs) were retrieved in the RDG group (17.6 ± 5.8 vs 15.8 ± 6.6, P = 0.018) with lower noncompliance rate (7.7% vs 16.9%, respectively, P = 0.006). Additionally, patients in the RDG group were more likely to initiate adjuvant chemotherapy earlier [median (interquartile range) postoperative days: 28 (24-32) vs 32 (26-42), P = 0.003]. Although total hospital costs were higher in the robotic group than in the laparoscopic group, the direct cost was lower for RDG than for LDG (all P < 0.001).

Conclusions: RDG is associated with a lower morbidity rate, faster recovery, milder inflammatory responses, and improved lymphadenectomy. Additionally, faster postoperative recovery in the RDG group enables early initiation of adjuvant chemotherapy. Our results provide evidence for the application of RDG in patients with GC.

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Conflict of interest statement

The authors report no conflicts of interest.

Comment in

References

    1. Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 1994; 4:146–148.
    1. Kim W, Kim HH, Han SU, et al. Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg 2016; 263:28–35.
    1. Hu Y, Huang C, Sun Y, et al. Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer: a randomized controlled trial. J Clin Oncol 2016; 34:1350–1357.
    1. Kim H-H, Han S-U, Kim M-C, et al. Effect of laparoscopic distal gastrectomy vs open distal gastrectomy on long-term survival among patients with stage I gastric cancer. JAMA Oncology 2019; 5:506–513.
    1. Yu J, Huang C, Sun Y, et al. Effect of laparoscopic vs open distal gastrectomy on 3-year disease-free survival in patients with locally advanced gastric cancer: the CLASS-01 Randomized clinical trial. JAMA 2019; 321:1983–1992.

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