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Surgical invasiveness and lymphadenectomy in robotic and laparoscopic gastrectomy: A retrospective study with propensity-score matching

      Highlights

      • Robotic gastrectomy (RG) retrieves more lymph nodes than laparoscopy in gastric cancer.
      • Specific areas of lymph nodes involved supra-pancreatic and lesser curvature areas.
      • RG is associated with decreased blood loss and lower CRP level than laparoscopic gastrectomy (LG).
      • No difference in complications, length of stay, or mortality between RG and LG.
      • RG could provide better surgical and oncological procedures than LG.

      Abstract

      Background

      There is no consensus amongst comparative studies about the advantages of robotic over laparoscopic surgeries for gastric cancer (GC). We compared invasiveness and lymph node dissection between robotic and laparoscopic gastrectomies (RG and LG).

      Methods

      We retrospectively reviewed the medical records of 215 consecutive patients with GC who underwent RG or LG with lymphadenectomy from January 2011–December 2020. Propensity score matching analysis was performed to control selection bias.

      Results

      The RG group had less operative blood loss (P = 0.0005) and higher C-reactive protein levels on postoperative day 1 (P = 0.0006) than the LG group. When analyzing the specific sites of dissected lymph nodes, station groups of supra-pancreatic and lesser curvature areas accounted for this difference (P = 0.0073 and 0.0362, respectively).

      Conclusions

      RG demonstrated lesser intraoperative bleeding, less of a postoperative inflammatory response, and a higher proportion of lymph node removal than LG, suggesting that it is a better surgical and oncological procedure.

      Keywords

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