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Comparison of Surgical Outcomes between Robotic and Laparoscopic Gastrectomy for Gastric Cancer: The Learning Curve of Robotic Surgery.

Kang BH, Xuan Y, Hur H, Ahn CW, Cho YK, Han SU - J Gastric Cancer (2012)

Bottom Line: The robotic gastrectomy patients were divided into 20 initial cases; and all subsequent cases; and we compared the clinicopathological features, operating times, and surgical outcomes between the three groups.The initial group had a longer average operating time (242.25±74.54 minutes vs. 192.56±39.56 minutes, P>0.001), and hospital stay (14.40±24.93 days vs. 8.66±5.39 days, P=0.001) than the experienced group.Our study shows that robotic gastrectomy is a safe and feasible procedure, especially after the 20 initial cases, and provides a satisfactory postoperative outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT

Purpose: Laparoscopic gastrectomy is a widely accepted surgical technique. Recently, robotic gastrectomy has been developed, as an alternative minimally invasive surgical technique. This study aimed to evaluate the question of whether robotic gastrectomy is feasible and safe for the treatment of gastric cancer, due to its learning curve.

Materials and methods: We retrospectively reviewed the prospectively collected data of 100 consecutive robotic gastrectomy patients, from November 2008 to March 2011, and compared them to 282 conventional laparoscopy patients during the same period. The robotic gastrectomy patients were divided into 20 initial cases; and all subsequent cases; and we compared the clinicopathological features, operating times, and surgical outcomes between the three groups.

Results: The initial 20 robotic gastrectomy cases were defined as the initial group, due to the learning curve. The initial group had a longer average operating time (242.25±74.54 minutes vs. 192.56±39.56 minutes, P>0.001), and hospital stay (14.40±24.93 days vs. 8.66±5.39 days, P=0.001) than the experienced group. The length of hospital stay was no different between the experienced group, and the laproscopic gastrectomy group (8.66±5.39 days vs. 8.11±4.10 days, P=0.001). The average blood loss was significantly less for the robotic gastrectomy groups, than for the laparoscopic gastrectomy group (93.25±84.59 ml vs. 173.45±145.19 ml, P<0.001), but the complication rates were no different.

Conclusions: Our study shows that robotic gastrectomy is a safe and feasible procedure, especially after the 20 initial cases, and provides a satisfactory postoperative outcome.

No MeSH data available.


Related in: MedlinePlus

(A) Comparison of the operating time among initial robotic, experienced robotic and laparoscopic gastrectpmy groups. (B) Comparison of the blood loss during the operation among the initial robotic, experienced robotic and laparoscopic gastrectomy groups. (C) Comparison of the length of hospital stay among the initial robotic, experienced robotic and laparoscopic gastrectomy groups. *Means P<0.05 by Tukey's honestly significant difference post-hoc test. Error bars represent standard error.
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Figure 4: (A) Comparison of the operating time among initial robotic, experienced robotic and laparoscopic gastrectpmy groups. (B) Comparison of the blood loss during the operation among the initial robotic, experienced robotic and laparoscopic gastrectomy groups. (C) Comparison of the length of hospital stay among the initial robotic, experienced robotic and laparoscopic gastrectomy groups. *Means P<0.05 by Tukey's honestly significant difference post-hoc test. Error bars represent standard error.

Mentions: The average age of the patients in the LG group was higher than that of the RG group, but there was no difference in average age between the initial and experienced groups (P=0.280). There was also no difference in complication rates among the three groups. All group had some total gastrectomy cases but there is no difference in complication rate between total gastrectomy and subtotal gastrectomy. The average operating time, blood loss and hospital stay showed statistically significant differences among the initial, experienced and laparoscopy groups in a one-way ANOVA analysis. Therefore, a post-hoc test was performed among these groups (Table 2). The average operating time was shorter in the laparoscopy group compared to the initial group (P<0.001), and the average operating time of the experienced group was shorter than that of the initial group (P<0.001). However, the experienced group had a longer average operating time than the laparoscopy group (P=0.006) (Fig. 4A). There was less blood loss in the RG groups than in the LG group (P<0.001 for initial, P=0.001 for experienced), but no differences were found between the initial and experienced groups (P=0.501) (Fig. 4B). The initial group had a longer average hospital stay than did the experienced (P=0.003) and laparoscopy (P<0.001) groups; however, no difference was found in hospital stay times between the experienced and laparoscopy groups (P=0.849) (Fig. 4C).


Comparison of Surgical Outcomes between Robotic and Laparoscopic Gastrectomy for Gastric Cancer: The Learning Curve of Robotic Surgery.

Kang BH, Xuan Y, Hur H, Ahn CW, Cho YK, Han SU - J Gastric Cancer (2012)

(A) Comparison of the operating time among initial robotic, experienced robotic and laparoscopic gastrectpmy groups. (B) Comparison of the blood loss during the operation among the initial robotic, experienced robotic and laparoscopic gastrectomy groups. (C) Comparison of the length of hospital stay among the initial robotic, experienced robotic and laparoscopic gastrectomy groups. *Means P<0.05 by Tukey's honestly significant difference post-hoc test. Error bars represent standard error.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3473222&req=5

Figure 4: (A) Comparison of the operating time among initial robotic, experienced robotic and laparoscopic gastrectpmy groups. (B) Comparison of the blood loss during the operation among the initial robotic, experienced robotic and laparoscopic gastrectomy groups. (C) Comparison of the length of hospital stay among the initial robotic, experienced robotic and laparoscopic gastrectomy groups. *Means P<0.05 by Tukey's honestly significant difference post-hoc test. Error bars represent standard error.
Mentions: The average age of the patients in the LG group was higher than that of the RG group, but there was no difference in average age between the initial and experienced groups (P=0.280). There was also no difference in complication rates among the three groups. All group had some total gastrectomy cases but there is no difference in complication rate between total gastrectomy and subtotal gastrectomy. The average operating time, blood loss and hospital stay showed statistically significant differences among the initial, experienced and laparoscopy groups in a one-way ANOVA analysis. Therefore, a post-hoc test was performed among these groups (Table 2). The average operating time was shorter in the laparoscopy group compared to the initial group (P<0.001), and the average operating time of the experienced group was shorter than that of the initial group (P<0.001). However, the experienced group had a longer average operating time than the laparoscopy group (P=0.006) (Fig. 4A). There was less blood loss in the RG groups than in the LG group (P<0.001 for initial, P=0.001 for experienced), but no differences were found between the initial and experienced groups (P=0.501) (Fig. 4B). The initial group had a longer average hospital stay than did the experienced (P=0.003) and laparoscopy (P<0.001) groups; however, no difference was found in hospital stay times between the experienced and laparoscopy groups (P=0.849) (Fig. 4C).

Bottom Line: The robotic gastrectomy patients were divided into 20 initial cases; and all subsequent cases; and we compared the clinicopathological features, operating times, and surgical outcomes between the three groups.The initial group had a longer average operating time (242.25±74.54 minutes vs. 192.56±39.56 minutes, P>0.001), and hospital stay (14.40±24.93 days vs. 8.66±5.39 days, P=0.001) than the experienced group.Our study shows that robotic gastrectomy is a safe and feasible procedure, especially after the 20 initial cases, and provides a satisfactory postoperative outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT

Purpose: Laparoscopic gastrectomy is a widely accepted surgical technique. Recently, robotic gastrectomy has been developed, as an alternative minimally invasive surgical technique. This study aimed to evaluate the question of whether robotic gastrectomy is feasible and safe for the treatment of gastric cancer, due to its learning curve.

Materials and methods: We retrospectively reviewed the prospectively collected data of 100 consecutive robotic gastrectomy patients, from November 2008 to March 2011, and compared them to 282 conventional laparoscopy patients during the same period. The robotic gastrectomy patients were divided into 20 initial cases; and all subsequent cases; and we compared the clinicopathological features, operating times, and surgical outcomes between the three groups.

Results: The initial 20 robotic gastrectomy cases were defined as the initial group, due to the learning curve. The initial group had a longer average operating time (242.25±74.54 minutes vs. 192.56±39.56 minutes, P>0.001), and hospital stay (14.40±24.93 days vs. 8.66±5.39 days, P=0.001) than the experienced group. The length of hospital stay was no different between the experienced group, and the laproscopic gastrectomy group (8.66±5.39 days vs. 8.11±4.10 days, P=0.001). The average blood loss was significantly less for the robotic gastrectomy groups, than for the laparoscopic gastrectomy group (93.25±84.59 ml vs. 173.45±145.19 ml, P<0.001), but the complication rates were no different.

Conclusions: Our study shows that robotic gastrectomy is a safe and feasible procedure, especially after the 20 initial cases, and provides a satisfactory postoperative outcome.

No MeSH data available.


Related in: MedlinePlus