A meta-analysis of robotic versus laparoscopic gastrectomy for gastric cancer

Shen, Weisong; Xi, Hongqing; Chen, Lin; Wei, Bo

doi:10.1007/s00464-014-3547-1

Cited by 86 publications

(59 citation statements)

References 35 publications

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“…As almost all of these studies have sample sizes of fewer than 100 cases and significant bias with regard to background factors, the reliability of the data is somewhat questionable. There have recently been eight reports released that conducted metaanalysis on the aforementioned reports altogether [53][54][55][56][57][58][59][60], which are listed in Table 2. However, since there have been no randomized comparative studies, it appears difficult to reach a clear conclusion even if a meta-analysis is performed.…”

Section: Robotic Gastrectomy For Gastric Cancermentioning

confidence: 99%

Robotic surgery for gastric cancer

et al. 2015

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Laparoscopic gastrectomy is a widely used minimally invasive surgery for gastric cancer. However, skillful techniques are required to perform lymph node dissection using straight shaped forceps, particularly for D2 dissection. Robotic surgery using the da Vinci surgical system is anticipated to be a powerful tool for performing difficult techniques using high-resolution three-dimensional (3D) images and the EndoWrist equipped with seven degrees of freedom. Attempts are being made to apply robotic surgery in gastrectomy procedures mainly in Japan, South Korea, and Europe. Although definite superiority to laparoscopic gastrectomy is yet to be proven, robotic surgery has been reported to have a shorter learning curve and offer more precise dissection for total gastrectomy. Hence, its oncological efficacy needs to be verified in a clinical trial.

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Section: Robotic Gastrectomy For Gastric Cancermentioning

confidence: 99%

Robotic surgery for gastric cancer

et al. 2015

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“…The author hypothesized that this was due to the surgeon's competence in laparoscopy and to some limits in robotic surgery, including the absence of tactile feedback and lack of various robotic instruments such as a suction-irrigator and endo-staplers. On the other hand, a number of retrospective studies [12,13] reported a significantly lower estimated blood loss during RAG than during laparoscopic and open surgery, as confirmed in several meta-analyses [1,15,21,28,30]. The use of robotics seems to reduce blood loss even in major and complex surgical procedures, because it allows for an extremely accurate and clean dissection especially during difficult procedures such as extended lymphadenectomies.…”

Section: Perioperative Outcomesmentioning

confidence: 94%

“…In most series and meta-analyses, the operative time of RAG was longer than in conventional laparoscopic or open surgery [1,10,11,13,16,21]. A more meticulous dissection, particularly along the vessels and during the lymphadenectomy, and an increased preference for intracorporeal anastomosis can partially explain the longer time of robotic procedures [2].…”

Section: Perioperative Outcomesmentioning

confidence: 99%

Robot-assisted gastrectomy for cancer

Bonapasta

Guerra

Linari

et al. 2016

Chirurg

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“…This study evaluated 1,875 patients who underwent either robotic gastrectomy or LAG. This analysis showed that RAG was associated with lower estimated blood loss, longer distal margin, and similar volume of harvested lymph nodes (39). In 2015, Coratti et al published a series of 98 consecutive robotic gastrectomies with D2 lymphadenectomy performed exclusively by two surgeons at a center in Italy.…”

Section: Robotic Surgery For Gastric Cancermentioning

confidence: 97%

Minimally invasive surgery for gastric cancer in USA: current status and future perspectives

Russo¹,

Strong²

2017

Transl. Gastroenterol. Hepatol.

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Abstract:The World Health Organization (WHO) has declared gastric carcinoma a global health concern and gastric cancer remains the third leading cause of cancer deaths worldwide. With the rising incidence of gastric cancer, a body of both retrospective and randomized data has emerged since the early 1990's evaluating the role of minimally invasive platforms in the management of gastric cancer. While Eastern studies have shown that the laparoscopic approach is safe and feasible for advanced gastric cancer in Eastern patients, it is not clear whether this is true for patients in the West. Differences in tumor biology, stage at presentation, institutional volume, and surgeon experience all may impact the efficacy and widespread utilization of minimally invasive approaches in regions where gastric cancer is less prevalent. The majority of studies have pointed to a number of improvements associated with minimally invasive approaches including decreased blood loss, shorter length of hospital stay, lower analgesic requirements, decreased minor complications, and faster recovery without any significant difference in overall or disease specific survival (DSS). The benefits associated with minimally invasive approaches and evidence supporting similar oncologic outcomes compared to the traditional open approach will hopefully expand the indications for minimally invasive surgery in the management of gastric cancer. In the United States, results following initial experiences with minimally invasive techniques, including robotic platforms, have revealed promising results.Well-established laparoscopic and robotic techniques are emerging, particularly from high volume United States institutions, which will hopefully pave the way for increased utilization of minimally invasive surgery for gastric cancer in the West.

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A meta-analysis of robotic versus laparoscopic gastrectomy for gastric cancer

Abstract: RAG is as acceptable as LAG for obtaining safe complications and for performing radical gastrectomy.

Cited by 86 publications

References 35 publications

Robotic surgery for gastric cancer

Robotic surgery for gastric cancer

Robot-assisted gastrectomy for cancer

Minimally invasive surgery for gastric cancer in USA: current status and future perspectives

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