title: Comparison of surgical performance and short-term clinical outcomes between laparoscopic and robotic surgery in distal gastric cancer.
abstract: OBJECTIVE
  The authors aimed to compare the surgical performance and the short-term clinical outcomes of robotic assisted laparoscopic distal gastrectomy (RADG) with laparoscopy-assisted distal gastrectomy (LADG) in distal gastric cancer patients.
  
  
  METHODS
  From April 2009 to August 2010, 62 patients underwent LADG and 30 patients underwent RADG for preoperative stage I distal gastric cancer by one surgeon at the National Cancer Center, Korea. Surgical performance was measured using lymph node (LN) dissection time and number of retrieved LNs, which were viewed as surrogates of technical ease and oncologic quality.
  
  
  RESULTS
  In clinicopathologic characteristics, mean age, depth of invasion and stage were significantly different between the LADG and RADG group. Mean dissection time at each LN station was greater in the RADG group, but no significant intergroup difference was found for numbers of retrieved LNs. Furthermore, proximal resection margins were smaller, and hospital costs were higher in the RADG group. In terms of the RADG learning curve, mean LN dissection time was smaller in the late RADG group (n = 15) than in the early RADG group (n = 15) for 4sb/4d, 5, 7-12a stations, but numbers of retrieved LNs per station were similar.
  
  
  CONCLUSIONS
  With the exception of operating time and cost, the numbers of retrieved LNs and the short-term clinical outcomes of RADG were found to be comparable to those of LADG, despite the surgeon's familiarity with LADG and lack of RADG experience. Further studies are needed to evaluate objectively ergonomic comfort and to quantify the patient benefits conferred by robotic surgery.
authors.affiliation: Gastric Cancer Branch, National Cancer Center, 111 Jeongbalsanro, Ilsandong-Gu, Goyang-Si, Gyeonggi-Do 410-769, South Korea.
authors.forename: B W
authors.initials: BW
authors.lastname: Eom
authors.forename: H M
authors.initials: HM
authors.lastname: Yoon
authors.forename: K W
authors.initials: KW
authors.lastname: Ryu
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.forename: S J
authors.initials: SJ
authors.lastname: Cho
authors.forename: J Y
authors.initials: JY
authors.lastname: Lee
authors.forename: C G
authors.initials: CG
authors.lastname: Kim
authors.forename: I J
authors.initials: IJ
authors.lastname: Choi
authors.forename: J S
authors.initials: JS
authors.lastname: Lee
authors.forename: M C
authors.initials: MC
authors.lastname: Kook
authors.forename: J Y
authors.initials: JY
authors.lastname: Rhee
authors.forename: S R
authors.initials: SR
authors.lastname: Park
authors.forename: Y W
authors.initials: YW
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012371:Robotics; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome