title: Robotic gastrectomy for elderly gastric cancer patients: comparisons with robotic gastrectomy in younger patients and laparoscopic gastrectomy in the elderly.
abstract: BACKGROUND
  Robotic surgery for gastric cancer has been adopted to overcome technical difficulties in performing laparoscopic gastrectomy. This study aimed to investigate the feasibility and safety of robotic gastrectomy in elderly gastric cancer patients.
  
  
  METHODS
  Patients who underwent laparoscopic or robotic gastrectomy from 2003 to 2010 in a single high-volume center were included in this study. We retrospectively compared preoperative characteristics, perioperative factors, and oncological parameters among an elderly (≥70 years old) robotic gastrectomy group (n = 49), a younger (<70 years old) robotic gastrectomy group (n = 321), and an elderly laparoscopic gastrectomy group (n = 132).
  
  
  RESULTS
  The elderly robotic group presented with more comorbidities than the younger robotic group. Except for number of retrieved lymph nodes (36.5 vs. 41.5; P = 0.007), short-term operative outcomes including complications and pathological parameters were comparable between the two robotic groups. The elderly robotic group showed comparable disease-specific survival to the younger robotic group although overall survival was worse. Compared to their laparoscopic counterparts, the elderly robotic group showed longer mean operation time (227 vs. 174 min). Nevertheless, the incidence and severity of postoperative complications was not different between the two elderly groups. Overall and disease-specific survival were also comparable between the elderly groups. In multivariate analysis, age and surgical approach were not risk factors for overall and major complications.
  
  
  CONCLUSIONS
  The outcomes of robotic gastrectomy in the elderly did not differ from those in younger robotic gastrectomy patients and were comparable to those in elderly patients who underwent laparoscopic gastrectomy. Thus, robotic gastrectomy could be a safe and feasible approach in elderly patients.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea.|Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Okumura
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.|Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, South Korea.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Taeil
authors.initials: T
authors.lastname: Son
authors.affiliation: Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, South Korea.|Department of Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
authors.forename: Yoo Min
authors.initials: YM
authors.lastname: Kim
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Hyoung-Il
authors.initials: HI
authors.lastname: Kim
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Ji Yeong
authors.initials: JY
authors.lastname: An
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. wjhyung@yuhs.ac.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea. wjhyung@yuhs.ac.|Robot and Minimally Invasive Surgery Center, Severance Hospital, Yonsei University Health System, Seoul, South Korea. wjhyung@yuhs.ac.
authors.forename: Woo Jin
authors.identifier: http://orcid.org/0000-0002-8593-9214
authors.initials: WJ
authors.lastname: Hyung
mesh_terms: D000368:Aged; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate
keywords: Elderly; Gastrectomy; Laparoscopy; Minimally invasive surgery; Robot