title: Robot-assisted total gastrectomy is comparable with laparoscopically assisted total gastrectomy for early gastric cancer.
abstract: BACKGROUND
  Laparoscopically assisted total gastrectomy (LATG) is technically difficult. Robot surgery has theoretical advantages such as increased degrees of freedom of instruments and a three-dimensional view. The current study aimed to determine whether a robot-assisted total gastrectomy (RATG) has a real benefit over LATG in terms of surgical and oncologic outcomes.
  
  
  METHODS
  A single-center case-control study was conducted. The study included 36 patients who underwent RATG and 65 patients who underwent LATG at the National Cancer Center in Korea between February 2009 and May 2011. No patients were excluded from the analysis within the study period. Clinicopathologic data, operative data, postoperative morbidity, and pathologic data were analyzed by Student's t-tests and Chi-square tests, as indicated.
  
  
  RESULTS
  The mean age of the patients was 53.9 ± 11.7 years in the RATG group and 56.9 ± 12.3 years in the LATG group (P = 0.236). The mean BMI was 23.2 ± 2.5 kg/m(2) in the RATG group and 23.6 ± 3.4 kg/m(2) in the LATG group (P = 0.494). The mean postoperative hospital stay was 8.8 ± 3.3 days in the RATG group and 10.3 ± 10.8 days in the LATG group (P = 0.416). The mean operative time was 305.8 ± 115.8 min in the RATG group and 210.2 ± 57.7 min in the LATG group (P < 0.001). The mean number of dissected lymph nodes was 42.8 ± 12.7 in the RATG group and 39.4 ± 13.4 in the LATG group (P = 0.209). Postoperative complications were experienced by 6 patients (16.7%) in the RATG group and 10 patients (15.4%) in the LATG group (P = 0.866).
  
  
  CONCLUSIONS
  Despite early experiences, RATG was shown to be comparable with LATG in terms of surgical and oncologic outcomes. However, no apparent benefit is associated with RATG to date.
authors.affiliation: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, 323 Ilsanro, Ilsandong-gu, Goyang-si, 411-769, Gyeonggi-do, Korea.
authors.forename: Hong Man
authors.initials: HM
authors.lastname: Yoon
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Keun Won
authors.initials: KW
authors.lastname: Ryu
authors.forename: Bang Wool
authors.initials: BW
authors.lastname: Eom
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Park
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.forename: Chan Gyoo
authors.initials: CG
authors.lastname: Kim
authors.forename: Jong Yeul
authors.initials: JY
authors.lastname: Lee
authors.forename: Soo Jeong
authors.initials: SJ
authors.lastname: Cho
authors.forename: Ji Yoon
authors.initials: JY
authors.lastname: Rho
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D012371:Robotics; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
references.citation: Arch Surg. 2011 Sep;146(9):1086-92
references.pmid: 21576595
references.citation: Am J Surg. 2007 Apr;193(4):519-22
references.pmid: 17368303
references.citation: Surg Endosc. 2007 Sep;21(9):1662-6
references.pmid: 17345142
references.citation: Surg Endosc. 2011 Feb;25(2):597-603
references.pmid: 20625770
references.citation: Surg Endosc. 2010 Mar;24(3):610-5
references.pmid: 19688399
references.citation: Ann Surg. 2008 Nov;248(5):721-7
references.pmid: 18948798
references.citation: Surg Endosc. 2008 Dec;22(12):2753-60
references.pmid: 18813994
references.citation: World J Surg. 2001 Nov;25(11):1467-77
references.pmid: 11760751
references.citation: J Laparoendosc Adv Surg Tech A. 2010 Oct;20(8):693-7
references.pmid: 20809816
references.citation: J Surg Oncol. 2009 Oct 1;100(5):392-5
references.pmid: 19598150
references.citation: Surg Endosc. 2010 Feb;24(2):377-82
references.pmid: 19536599
references.citation: Surg Endosc. 2010 Mar;24(3):584-8
references.pmid: 19633893
references.citation: Ann Surg. 2006 Apr;243(4):486-91
references.pmid: 16552199
references.citation: Ann Surg. 2009 Jun;249(6):927-32
references.pmid: 19474671
references.citation: Surg Laparosc Endosc. 1994 Apr;4(2):146-8
references.pmid: 8180768
references.citation: Surg Endosc. 2011 Jan;25(1):240-8
references.pmid: 20552367
references.citation: Eur J Obstet Gynecol Reprod Biol. 2010 May;150(1):92-6
references.pmid: 20207063
references.citation: Surg Clin North Am. 2003 Dec;83(6):1429-44
references.pmid: 14712877
references.citation: Surg Endosc. 2009 Jun;23(6):1204-11
references.pmid: 19263147