Controlled Study Of Clinical Effects Between Robotic Total Gastrectomy And Laparoscopic Total Gastrectomy For Gastric Cancer

Objectives:Comparing the clinical outcomes between robotic-assisted total gastrectomy and laparoscopic-assisted total gastrectomy for gastric cancer,in order to assess the safety and feasibility of robotic total gastrectomy as a new minimally invasive surgical way.Methods:The patients’ clinical data: 30 cases underwent robotic-assisted total gastrectomy and 45 cases underwent the laparoscopic-assisted total gastrectomy way.All of the patients were admitted from December 2014 to February 2016 in Department of General Surgery,the First Affiliated Hospital of Nanchang University.The data were systematically searched and retrospectively analyzed.Operative situation and post-operative short-term clinical effects were compared between the robotic-assisted total gastrectomy group and laparoscopic-assisted total gastrectomy group.Results:1、Both groups finished the operation smoothly and conducted D2 Radical total gastrectomy.2、There was no significant difference(P>0.05)between the two groups in Patients’ general data,such as age 、sex、pre-operative body mass index(BMI)and previous history of abdominal operation,et al.There also no difference in Patients’ pre-operative related clinical indicators.3、Compared with the laparoscopic-assisted total gastrectomy group,Intra-operative blood loss was significantly less[(143.9±109.2)mL vs.(205.6±132.6)mL,P=0.044 ]and The 24 hour pain was fewer(P=0.038)in the robotic group.4、In terms of post-operative pathological data and the carcinoma’s clinical pathological stage,such as distal margin length、positive surgical margin 、resected lymph nodes number、T stage、N stage、TNM stage and so on,there were no significant differences(P>0.05)between the two groups.5、During a post-operative follow-up period range from 30 to 983 days(median 706 days),there were 8(28.6%)patients experienced relapse and metastasis and 4(14.3%)patients died of the disease in robotic group and 10(26.3%)patients experienced relapse and metastasis and 7(18.4%)patients died of the disease in laparoscopic group,but both were no differences(P>0.05)in two groups.6、for the postoperative duration,The 1-year overall survival rate was 93.0% for the robotic group and 88.9% for the laparoscopic group and The 2-year overall survival rate was 87.7% for the robotic group and 87.5% for the laparoscopic group,There were no statistically significant differences in overall survival rate between the two groups(P=0.759).Besides,The 1-year disease-free survival rate was 81.5% for the robotic group and 83.6% for the laparoscopic group and The 2-year disease-free survival rate was 52.1% for the robotic group and 64.8% for the laparoscopic group,There were no statistically significant differences in disease-free survival rate between the two groups(P=0.703).Conclusion:Robotic-assited total gastrectomy is safe and feasible in the treatment of gastric cancer.with respect to minimally invasive surgical effects and oncological outcomes are comparable to laparoscopic-assited total gastrectomy.But,roboticc-assited total gastrectomy group have less intra-operative blood loss and lead fewer The 24 hour pain.no significant difference in the ratio of recurrence and metastasis and the short-term survival time between the two groups.