Kecheng Zhang, Lin Chen, Hongqing Xi, Jianxin Cui, Xiaosong Wu, Yunhe Gao, Wenquan Liang, Chong Hu, Jiyang Li. Chinese People’s Liberation Army of General Hospital
INTRODUCTION: With the increasing incidence of early gastric cancer in the upper stomach, more attention has been paid to minimally invasive function-preserving gastrectomy. In this context, we aim to compare the oncological outcomes, surgical stress and nutritional status between robotic and laparoscopic proximal gastrectomy.
METHODS: A total of 89 patients with clinical stage I gastric cancer in the upper stomach between November 2011 and December 2013 were enrolled in this retrospective study. Among them, 27 patients underwent robotic proximal gastrectomy (RPG), while 62 patients underwent laparoscopic proximal gastrectomy (LPG). Perioperative parameters, surgical stress, nutritional status, disease-free survival and overall survival were compared between the two groups.
RESULTS: Patients in RPG group and LPG group were well balanced in terms of gender, age and comorbidity. There were similar perioperative outcomes regarding operation time, complications and length of hospital stay between the two groups. However, patients of RPG group have less blood loss (p = 0.024), more harvested lymph nodes (p = 0.021) and higher cost (p < 0.001). As for surgical stress, no significant difference was observed for C-reactive protein concentration and white blood cell count on postoperative day 1, 3 and 7 between two groups. Compared with patients in LPG group, there seemed to have higher hemoglobin level and body mass index in 6 month (p = 0.053) and 12 month (p = 0.056) postoperatively for patients who underwent RPG, though the difference was not statistically significant. Similar disease-free survival and overall survival was observed between the two groups.
CONCLUSIONS: Robotic proximal gastrectomy could be an alternative for laparoscopic proximal gastrectomy for patients with early gastric cancer in the upper location with potential improvement of nutritional status. Further well-designed, prospective large-scale studies are needed to validate these results.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77653
Program Number: S033
Presentation Session: Gastric
Presentation Type: Podium
sages_adbutler_leaderboard