Trends in clinical outcomes and long-term survival after robotic gastrectomy for gastric cancer: a single high-volume center experience of consecutive 2000 patients

Background Minimally invasive surgery is now a standard treatment for gastric cancer. Many retrospective studies have reported that robotic gastrectomy is safe and feasible, with similar short- and long-term outcomes as laparoscopic gastrectomy. However, no studies have reported the details of surgi...

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Published in:Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2022, Vol.25 (1), p.275-286
Main Authors: Choi, Seohee, Song, Jeong Ho, Lee, Sejin, Cho, Minah, Kim, Yoo Min, Kim, Hyoung-Il, Hyung, Woo Jin
Format: Article
Language:English
Subjects:
Abdominal Surgery
Cancer Research
Clinical outcomes
Gastrectomy
Gastrectomy - methods
Gastric cancer
Gastroenterology
Gastrointestinal surgery
Humans
Laparoscopy
Laparoscopy - methods
Medicine
Medicine & Public Health
Oncology
Original Article
Patients
Retrospective Studies
Robotic surgery
Robotic Surgical Procedures - adverse effects
Robotics
Stomach Neoplasms - surgery
Surgical Oncology
Survival
Treatment Outcome
Trends
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Summary:Background Minimally invasive surgery is now a standard treatment for gastric cancer. Many retrospective studies have reported that robotic gastrectomy is safe and feasible, with similar short- and long-term outcomes as laparoscopic gastrectomy. However, no studies have reported the details of surgical and survival outcomes for robotic gastrectomy. This study aimed to evaluate the surgical trends and techniques of robotic gastrectomy and analyze the surgical outcomes of 2000 consecutive patients with gastric cancer who underwent robotic gastrectomy over 14 years. Methods Between July 2005 and January 2019, 2000 consecutive robotic gastrectomies were performed. We evaluated short- and long-term outcomes as well as surgical trends after robotic gastrectomy. Results There were 1,560 subtotal gastrectomies (78%), 324 total gastrectomies (16.2%), 83 proximal gastrectomies (4.2%), and 33 completion total gastrectomies (1.7%). The rates of major complications and mortality were 3.1% and 0.3%, respectively. In a subgroup analysis, there were no significant differences in the rate of complications over time ( P  = 0.696). Five-year overall survival rates were 97.6% for stage I, 91.9% for stage II, and 69.2% for stage III, with a total recurrence rate of 5.3%. Since its adoption in 2005, the proportion of robotic gastrectomies, as well as technically demanding procedures have increased over time. Conclusions Our 14 years’ experience of 2000 robotic gastrectomies has shown the proportion, as well as the number of robotic gastrectomies, have tended to increase and trends toward to technically demanding procedures. Outcomes of robotic gastrectomy appear safe and feasible with acceptable short- and long-term outcomes.
ISSN:1436-3291
1436-3305
DOI:10.1007/s10120-021-01231-3