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, 10 (1), 485

Comparison of Surgical Outcomes Between Integrated Robotic and Conventional Laparoscopic Surgery for Distal Gastrectomy: A Propensity Score Matching Analysis

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Comparison of Surgical Outcomes Between Integrated Robotic and Conventional Laparoscopic Surgery for Distal Gastrectomy: A Propensity Score Matching Analysis

Chul Kyu Roh et al. Sci Rep.

Abstract

This study was aimed to compare the surgical outcomes between conventional laparoscopic distal gastrectomy (CLDG) and integrated robotic distal gastrectomy (IRDG) which used both Single-Site platform and fluorescence image-guided surgery technique simultaneously. Retrospective data of 56 patients who underwent IRDG and 152 patients who underwent CLDG were analyzed. Propensity score matching analysis was performed to control selection bias using age, sex, American Society of Anesthesiologists score, and body mass index. Fifty-one patients were selected for each group. Surgical success was defined as the absence of open conversion, readmission, major complications, positive resection margin, and inadequate lymph node retrieval (<16). Patients characteristics and surgical outcomes of IRDG group were comparable to those of CLDG group, except longer operation time (159.5 vs. 131.7 min; P < 0.001), less blood loss (30.7 vs. 73.3 mL; P = 0.004), higher number of retrieved lymph nodes (LNs) (50.4 vs. 41.9 LNs; P = 0.025), and lower readmission rate (2.0 vs. 15.7%; P = 0.031). Surgical success rate was higher in IRDG group compared to CLDG group (98.0 vs. 82.4%; P = 0.008). In conclusion, this study found that IRDG provides the benefits of higher number of retrieved LNs, less blood loss, and lower readmission rate compared with CLDG in patients with early gastric cancer.

Conflict of interest statement

H.I. Kim was funded by the grant from a National Research Foundation of Korea (NRF). The authors declare no other competing interests.

Figures

Figure 1
Figure 1
Endoscopic indocyanine green injection. (A) Submucosal injection of indocyanine green at the day before surgery (B) Post-injection view.
Figure 2
Figure 2
Reduced-port robotic gastrectomy. (A) Schematic illustration of reduced-port robotic distal gastrectomy using da Vinci Xi. (B) External view after installation Figure 2A is produced by MID (Medical Illustration & Design), a part of the Medical Research Support Services of Yonsei University College of Medicine, which is available under the Creative Commons Attribution 4.0 International License. (https://creativecommons.org/licenses/by/4.0/). DOF, degrees of freedom.
Figure 3
Figure 3
Fluorescence guided lymph node dissection. (A) Lymph nodes in white light. (B) fluorescence image visualizing lymph node.
Figure 4
Figure 4
Surgical wound. A drain is inserted via right trocar site. Umbilicus was closed with subcuticular suture.

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