Comparative study of the outcomes of robotic versus laparoscopic distal gastrectomy with hand-sewn anastomosis in Billroth-I reconstruction

机器人辅助远端胃切除术与腹腔镜远端胃切除术联合手工缝合吻合术在毕氏I式重建术中疗效的比较研究

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Abstract

PURPOSE: Total laparoscopic distal gastrectomy hand-sewn anastomosis (LDG-HA) for gastric cancer (GC) is safe and effective. The objectives of our study were to investigate the efficacy and safety of laparoscopic versus robotic distal gastrectomy hand-sewn anastomosis (RDG-HA) in Billroth-I reconstruction. METHODS: We retrospectively analyzed the clinical data of 95 patients treated with LDG-HA (n = 55) and RDG-HA (n = 40) for GC from 09/2018 to 06/2021. The effects on baseline, pathology, perioperative data, short-term outcomes, long-term outcomes and 5-year oncologic outcomes follow-up were analyzed. RESULTS: The difference between the clinical-pathological characteristics of the two groups was not statistically significant (P > 0.05). The RDG-HA group was associated with a shorter anastomosis time (20.80 min vs. 23.36 min, P = 0.001) but a longer operative time (176.55 vs. 151.86 min, P = 0.003) and a higher cost (97661.66 CNY vs. 71082.63 CNY, P = 0.000). The differences of complications, 5-year follow-up overall survival and disease-free survival rates between the two groups were not statistically significant. CONCLUSION: RDG-HA is safe and effective with a faster procedure of reconstruction but much more expensive.

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