Enhanced recovery and comparable long-term outcomes in reduced-port robotic distal gastrectomy versus conventional laparoscopic distal gastrectomy: A propensity score-matched analysis of single-center experience

Abstract

Introduction: Reduced-port robotic distal gastrectomy (REPRODG) combines reduced-port surgery with robotic assistance to further optimize surgical outcomes. While the advantages of both reduced-port and robotic approaches over conventional laparoscopic surgery remain controversial, evaluating these techniques together may reveal potential benefits not observed when assessed separately. This study aimed to compare the surgical and oncologic outcomes of REPRODG to those of conventional laparoscopic distal gastrectomy (CLDG).

Materials and methods: We conducted a retrospective analysis of 1865 patients with gastric cancer who underwent either REPRODG or CLDG between January 2015 and December 2018. Utilizing 1:1 propensity score matching, we compared short- and long-term outcomes between the groups.

Results: A total of 174 matched pairs of REPRODG and CLDG patients were analyzed. The REPRODG group demonstrated a shorter hospital stay (p = 0.006) and faster time to the first flatus (p = 0.001), and a lower incidence of pulmonary complications (p = 0.044) compared to the CLDG group. No significant differences were observed in overall and recurrence-free survival between the two groups (p = 0.739 and 0.564, respectively).

Conclusions: This study suggests that REPRODG may provide better short-term surgical outcomes to CLDG, particularly faster postoperative recovery, while maintaining comparable oncologic outcomes. Integrating robotic technology into reduced-port distal gastrectomy may further optimize postoperative recovery.

Keywords: Distal gastrectomy; Gastric cancer; Laparoscopic gastrectomy; Reduced-port surgery; Robotic gastrectomy.