114O - Assessment of robotic versus laparoscopic distal gastrectomy for gastric cancer: A randomized controlled trial

Background

Despite the increasing use of robotic distal gastrectomy (RDG) in patients with gastric cancer (GC), its safety and efficacy compared to those of laparoscopic distal gastrectomy (LDG) have not been elucidated in a randomized controlled trial (RCT). We aimed to evaluate the short-term outcomes of patients with GC who received RDG or LDG.

Methods

Three hundred patients with cT1-4a and N0/+ between September 2017 and January 2020 were enrolled in this RCT at a high-volume hospital in China. The short-term outcomes were compared between the groups.

Results

The modified intention-to-treat analysis included data from 283 patients (RDG group: n=141) and (LDG group: n=142). Patients in the RDG group exhibited faster postoperative recovery, milder inflammatory responses, and reduced postoperative morbidity (9.2% vs. 17.6%, respectively, p=0.039). Higher extraperigastric lymph nodes (LNs) were retrieved in the RDG group (17.6 ± 5.8 vs. 15.8 ± 6.6, p=0.018) with lower noncompliance rate (7.7% vs. 16.9%, respectively, p=0.006). Additionally, patients in the RDG group were more likely to initiate adjuvant chemotherapy earlier (median [interquartile range] postoperative days: 28 [24-32] vs. 32 [26-42], p=0.003). Although total hospital costs were higher in the robotic group than in the laparoscopic group, the direct cost was lower for RDG than for LDG (all p<0.001).

Conclusions

RDG is associated with a lower morbidity rate, faster recovery, milder inflammatory responses, and improved lymphadenectomy. Additionally, faster postoperative recovery in the RDG group enables early initiation of adjuvant chemotherapy. Our results provide evidence for the application of RDG in patients with GC.

Clinical trial identification

NCT03313700.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Scientific and Technological Innovation Joint Capital Projects of Fujian Province.

Disclosure

All authors have declared no conflicts of interest.