title: Robotic gastrectomy as an oncologically sound alternative to laparoscopic resections for the treatment of early-stage gastric cancers.
abstract: OBJECTIVE
  To evaluate the comparative safety and efficacy of robotic vs laparoscopic gastrectomy for early-stage gastric cancer.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Tertiary hospital.
  
  
  METHODS
  Eight hundred twenty-seven patients with gastric cancer.
  
  
  METHODS
  Between July 2005 and April 2009, 827 patients with gastric cancer underwent 236 robotic and 591 laparoscopic radical gastrectomies with curative intent. The patients' data were prospectively collected and retrospectively analyzed.
  
  
  METHODS
  We performed a comparative analysis between the robotic surgery group and laparoscopic surgery group for preoperative patient characteristics, intraoperative factors, and postoperative morbidity and mortality.
  
  
  RESULTS
  The robotic group was younger than the laparoscopic group, but other preoperative patient characteristics did not differ. The mean operative time for the robotic group (219.5 minutes) was on average 49 minutes longer than the laparoscopic group (170.7 minutes) (P < .001), while mean blood loss was significantly less in the robotic group (91.6 mL vs 147.9 mL; P = .002). The robotic group had mortality of 0.4% and morbidity of 11.0%, comparable with those of the laparoscopic group (P > .05). The number of lymph nodes retrieved per level was adequate in both groups and did not differ significantly. Robotic D1+α (n = 5), D1+β (n = 126), and D2 (n = 105) dissections retrieved 27.2, 36.7, and 42.4 mean numbers of lymph nodes, respectively. Except for 3 cases in the laparoscopic group, all specimens had negative margins.
  
  
  CONCLUSIONS
  Our largest comparative study demonstrates robotic gastrectomy to have better short-term and comparable oncologic outcomes compared with laparoscopic gastrectomy. A robotic approach to gastric cancer is a promising alternative to laparoscopic surgery.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yanghee
authors.initials: Y
authors.lastname: Woo
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
authors.forename: Kyung-Ho
authors.initials: KH
authors.lastname: Pak
authors.forename: Kazuki
authors.initials: K
authors.lastname: Inaba
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Obama
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012371:Robotics; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome