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. 2023 Aug 9;408(1):302.
doi: 10.1007/s00423-023-03032-x.

Open vs robotic gastrectomy with D2 lymphadenectomy: a propensity score-matched analysis on 1469 patients from the IMIGASTRIC prospective database

Stefano Trastulli  1 , Jacopo Desiderio  1 , Jian-Xian Lin  2 , Daniel Reim  3 , Chao-Hui Zheng  2 , Felice Borghi  4 , Fabio Cianchi  5 , Enrique Norero  6 , Ninh T Nguyen  7 , Feng Qi  8 , Andrea Coratti  9 , Maurizio Cesari  10 , Francesca Bazzocchi  11 , Orhan Alimoglu  12 , Steven T Brower  13 , Graziano Pernazza  14 , Simone D'Imporzano  15 , Juan-Santiago Azagra  16 , Yan-Bing Zhou  17 , Shou-Gen Cao  17 , Francesco Guerra  9 , Tong Liu  8 , Giacomo Arcuri  18 , Paulina González  6 , Fabio Staderini  5 , Alessandra Marano  4 , Domenico Di Nardo  1 , Amilcare Parisi  1 , Chang-Ming Huang  2 , Giovanni Domenico Tebala  19
Affiliations

Open vs robotic gastrectomy with D2 lymphadenectomy: a propensity score-matched analysis on 1469 patients from the IMIGASTRIC prospective database

Stefano Trastulli et al. Langenbecks Arch Surg. .

Abstract

Background: Comparative data on D2-robotic gastrectomy (RG) vs D2-open gastrectomy (OG) are lacking in the Literature. Aim of this paper is to compare RG to OG with a focus on D2-lymphadenectomy.

Study design: Data of patients undergoing D2-OG or RG for gastric cancer were retrieved from the international IMIGASTRIC prospective database and compared.

Results: A total of 1469 patients were selected for inclusion in the study. After 1:1 propensity score matching, a total of 580 patients were matched and included in the final analysis, 290 in each group, RG vs OG. RG had longer operation time (210 vs 330 min, p < 0.0001), reduced intraoperative blood loss (155 vs 119.7 ml, p < 0.0001), time to liquid diet (4.4 vs 3 days, p < 0.0001) and to peristalsis (2.4 vs 2 days, p < 0.0001), and length of postoperative stay (11 vs 8 days, p < 0.0001). Morbidity rate was higher in OG (24.1% vs 16.2%, p = 0.017).

Conclusion: RG significantly expedites recovery and reduces the risk of complications compared to OG. However, long-term survival is similar.

Keywords: D2-lymphadenectomy; Gastric cancer; Open gastrectomy; Robotic gastrectomy.

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