title: Robotic versus laparoscopic gastrectomy for gastric cancer: comparison of short-term surgical outcomes.
abstract: BACKGROUND
  Robot-assisted gastrectomy (RAG) is a new minimally invasive surgical technique for gastric cancer. This study was designed to compare RAG with laparoscopy-assisted gastrectomy (LAG) in short-term surgical outcomes.
  
  
  METHODS
  Between October 2011 and August 2014, 423 patients underwent robotic or laparoscopic gastrectomy for gastric cancer: 93 RAG and 330 LAG. We performed a comparative analysis between RAG group and LAG group for clinicopathological characteristics and short-term surgical outcomes.
  
  
  RESULTS
  RAG was associated with a longer operative time (P < 0.001), lower blood loss (P = 0.001), and more harvested lymph nodes (P = 0.047). Only three patients in LAG group had positive margins, and R0 resection rate for RAG and LAG was similar (P = 0.823). The RAG group had postoperative complications of 9.8 %, comparable with those of the LAG group (P = 0.927). Proximal margin, distal margin, hospital stay, days of first flatus, and days of eating liquid diet for RAG and LAG were similar. In the subgroup of serosa-negative patients, RAG had a longer operation time (P = 0.003), less intraoperative blood loss (P = 0.005), and more harvested lymph nodes (P = 0.04). However, in the subgroup of serosa-positive patients, RAG had a longer operation time (P = 0.001), but no less intraoperative blood loss (P = 0.139) and no more harvested lymph nodes (P = 0.139). Similarly, in the subgroup of total gastrectomy patients, RAG had a longer operation time (P = 0.018), but no less intraoperative blood loss (P = 0.173).
  
  
  CONCLUSIONS
  The comparative study demonstrates that RAG is as acceptable as LAG in terms of surgical and oncologic outcomes. With lower estimated blood loss, acceptable complications, and radical resection, RAG is a promising approach for the treatment of gastric cancer. However, the indication of patients for RAG is critical.
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Weisong
authors.initials: W
authors.lastname: Shen
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Hongqing
authors.initials: H
authors.lastname: Xi
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wei
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Jianxin
authors.initials: J
authors.lastname: Cui
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Shibo
authors.initials: S
authors.lastname: Bian
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Kecheng
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China. huangxhbj@163.com.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China. chenlinbj@163.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Gastric neoplasm; Laparoscopy-assisted gastrectomy; Robot-assisted gastrectomy