Purpose Various studies have indicated that reduced-port robotic gastrectomies are safe and feasible for treating patients with early gastric cancer. However, there have not been any comparative studies conducted that have evaluated patients with clinically advanced gastric cancer. Therefore, we aimed to compare the perioperative outcomes of D2 lymph node dissections during reduced-port robotic distal subtotal gastrectomies (RRDGs) and conventional 5-port laparoscopic distal subtotal gastrectomies (CLDGs). Materials and Methods We retrospectively evaluated 118 patients with clinically advanced gastric cancer who underwent minimally invasive distal subtotal gastrectomies with D2 lymph node dissections between February 2016 and November 2019. To evaluate the patient data, we performed a 1:1 propensity score matching (PSM) according to age, sex, body mass index, American Society of Anesthesiologists physical status classification score, and clinical T status. The short-term surgical outcomes were also compared between the two groups. Results The PSM identified 40 pairs of patients who underwent RRDG or CLDG. The RRDG group experienced a significantly longer operation time than the CLDG group (P<0.001), although the RRDG group had significantly less estimated blood loss (P=0.034). The number of retrieved extraperigastric lymph nodes in the RRDG group was significantly higher than that of the CLDG group (P=0.008). The rate of postoperative complications was not significantly different between the two groups (P=0.115). Conclusions D2 lymph node dissections can be safely performed during RRDGs and the perioperative outcomes appear to be comparable to those of conventional laparoscopic surgeries. Further studies are needed to compare long-term survival outcomes.

中文翻译：

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D2 在大容量中心单外科医生进行的小口机器人远端胃大部切除术和常规腹腔镜手术中的淋巴结清扫：倾向评分匹配分析

目的 各种研究表明，减少端口的机器人胃切除术对于治疗早期胃癌患者是安全可行的。然而，还没有任何比较研究对临床晚期胃癌患者进行评估。因此，我们旨在比较减少端口机器人远端胃大部切除术 (RRDGs) 和传统 5 端口腹腔镜远端胃大部切除术 (CLDGs) 期间 D2 淋巴结清扫术的围手术期结果。材料与方法 我们回顾性评估了 2016 年 2 月至 2019 年 11 月期间接受微创远端胃大部切除术和 D2 淋巴结清扫术的 118 名临床晚期胃癌患者。为了评估患者数据，我们进行了 1:1 倾向评分匹配 (PSM)根据年龄、性别、体重指数、美国麻醉医师协会身体状态分类评分和临床 T 状态。还比较了两组的短期手术结果。结果 PSM 确定了 40 对接受 RRDG 或 CLDG 的患者。RRDG 组的手术时间明显长于 CLDG 组（P<0.001），尽管 RRDG 组的估计失血量显着减少（P=0.034）。RRDG组胃外淋巴结取回数显着高于CLDG组（P=0.008）。两组术后并发症发生率无显着差异（P=0.115）。结论 D2 淋巴结清扫可以在 RRDG 期间安全地进行，并且围手术期结果似乎与传统腹腔镜手术相当。需要进一步的研究来比较长期生存结果。