• Qi-Yue Chen, Qing Zhong, Zhi-Yu Liu, Ping Li, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Long-Long Cao, Mi Lin, Ru-Hong Tu, Ze-Ning Huang, Ju-Li Lin, Hua-Long Zheng, Guang-Tan Lin, Chao-Hui Zheng, Chang-Ming Huang, and Jian-Wei Xie.
• Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
• Ann. Surg. 2022 Nov 1; 276 (5): e434-e443.

ObjectiveTo compare the short-term outcomes, surgery burden, and technical performance of robotic total gastrectomy (RTG) and laparoscopic total gastrectomy (LTG) for gastric cancer (GC).Summary Of Background DataThe impact of robotic systems on total gastrectomy remains obscure.MethodsThis prospective study included 50 patients with advanced proximal GC underwent RTG combined with spleen-preserving splenic hilar lymphadenectomy between March 2018 and February 2020. Patients who underwent LTG in the FUGES-002, http://links.lww.com/SLA/C929 study were enrolled to compare the outcomes between RTG and LTG.ResultsAfter propensity score matching, 48 patients in the RTG group and 96 patients in the LTG group were included in the analysis. The RTG group had a lower volume of intraoperative blood loss than the LTG group (38.7 vs 66.4 mL, P = 0.042). Significantly more extraperigastric lymph nodes were retrieved in the RTG group than in the LTG group (20.2 vs 17.5, P = 0.039). The average number of errors was lower in the RTG group than in the LTG group (43.2 vs 53.8 times/case, P < 0.001). The RTG group had a higher technical skill score (30.2 vs 28.4, P < 0.001) and a lower surgery task load index (33.2 vs 39.8, P < 0.001) than the LTG group. No significant difference was found in terms of postoperative morbidity between the 2 groups (14.6% vs 16.7%, P = 0.748).ConclusionsIn complex total gastrectomy for GC, compared with traditional laparoscopic surgery, robotic surgery provides a technically superior operative environment and reduces surgeon workload at high-volume specialized institutions.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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