title: Who may benefit from robotic gastrectomy?: A subgroup analysis of multicenter prospective comparative study data on robotic versus laparoscopic gastrectomy.
abstract: OBJECTIVE
  Robotic gastrectomy for gastric cancer has been proven to be a feasible and safe minimally invasive procedure. However, our previous multicenter prospective study indicated that robotic gastrectomy is not superior to laparoscopic gastrectomy. This study aimed to identify which subgroups of patients would benefit from robotic gastrectomy rather than from conventional laparoscopic gastrectomy.
  
  
  METHODS
  A prospective multicenter comparative study comparing laparoscopic and robotic gastrectomy was previously conducted. We divided the patients into subgroups according to obesity, type of gastrectomy performed, and extent of lymph node dissection. Surgical outcomes were compared between the robotic and laparoscopic groups in each subgroup.
  
  
  RESULTS
  A total of 434 patients were enrolled into the robotic (n = 223) and laparoscopic (n = 211) surgery groups. According to obesity and gastrectomy type, there was no difference in the estimated blood loss (EBL), number of retrieved lymph nodes, complication rate, open conversion rate, and the length of hospital stay between the robotic and laparoscopic groups. According to the extent of lymph node dissection, the robotic group showed a significantly lower EBL than did the laparoscopic group after D2 dissection (P = 0.021), while there was no difference in EBL in patients that did not undergo D2 dissection (P = 0.365).
  
  
  CONCLUSIONS
  Patients with gastric cancer undergoing D2 lymph node dissection can benefit from less blood loss when a robotic surgery system is used.
authors: Department of Surgery, Chung-Ang University College of Medicine, Seoul, South Korea.
authors: J M
authors: JM
authors: Park
authors: Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
authors: H I
authors: HI
authors: Kim
authors: Department of Surgery, Ajou University College of Medicine, Gyeonggido, South Korea.
authors: S U
authors: SU
authors: Han
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors: H K
authors: HK
authors: Yang
authors: Center for Gastric Cancer, National Cancer Center, Gyeonggido, South Korea.
authors: Y W
authors: YW
authors: Kim
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors: H J
authors: HJ
authors: Lee
authors: Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
authors: J Y
authors: JY
authors: An
authors: Department of Surgery, Dong-A University College of Medicine, Busan, South Korea.
authors: M C
authors: MC
authors: Kim
authors: Department of Surgery, Korea University College of Medicine, Seoul, South Korea.
authors: S
authors: S
authors: Park
authors: Department of Surgery, The Catholic University of Korea, Seoul, South Korea.
authors: K Y
authors: KY
authors: Song
authors: Department of Surgery, Inje University College of Medicine, Busan, South Korea.
authors: S J
authors: SJ
authors: Oh
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors: S H
authors: SH
authors: Kong
authors: Department of Surgery, Inje University College of Medicine, Busan, South Korea.
authors: B J
authors: BJ
authors: Suh
authors: Department of Surgery, Hallym University College of Medicine, Seoul, South Korea.
authors: D H
authors: DH
authors: Yang
authors: Department of Surgery, Hanyang University College of Medicine, Seoul, South Korea.
authors: T K
authors: TK
authors: Ha
authors: Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
authors: W J
authors: WJ
authors: Hyung
authors: Center for Gastric Cancer, National Cancer Center, Gyeonggido, South Korea. Electronic address: docryu@korea.com.
authors: K W
authors: KW
authors: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D015897:Comorbidity; D061887:Conversion to Open Surgery; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Gastric cancer; Laparoscopy; Robotic surgery; Surgical outcome