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Lower rate of conversion using robotic-assisted surgery compared to laparoscopy in completion total gastrectomy for remnant gastric cancer

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Abstract

Background

Completion total gastrectomy with radical lymphadenectomy for remnant gastric cancer is a technically demanding procedure. No previous studies have compared laparoscopic to robotic-assisted completion gastrectomy, whereas a few small case series have reported benefits of minimally invasive surgery over open surgery. The aim of this study is to assess the effectiveness and feasibility of robotic-assisted compared with laparoscopic completion gastrectomy for the treatment of remnant gastric cancer.

Methods

We retrospectively reviewed data from 55 patients who underwent minimally invasive completion gastrectomy for remnant gastric cancer at the Severance Hospital of Yonsei University Health System from April 2005 to July 2017. Of the 55 patients, 30 patients underwent laparoscopic and 25 underwent robotic-assisted completion total gastrectomy. We compared the patients’ demographics, operative outcomes, and postoperative outcomes.

Results

Operation time was longer in the robotic-assisted surgery group (225 vs 292 min, P < 0.001), but both groups had similar estimated blood loss. The laparoscopic surgery group had a 13.3% (four patients) rate of conversion to open surgery because of severe adhesions, whereas no patients in the robotic group underwent conversion to laparoscopic or open surgery (P = 0.058). Mean hospital stay, postoperative complications, and recovery were similar in both groups. Pathology results, including the number of retrieved lymph nodes, did not differ between groups.

Conclusion

Laparoscopic and robotic approaches are both feasible and safe for remnant gastric cancer, with comparable short-term outcomes. However, the robotic approach demonstrated a lower conversion rate than laparoscopy, although the statistical difference was marginal.

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References

  1. Kwon IG, Cho I, Guner A, Choi YY, Shin HB, Kim HI et al (2014) Minimally invasive surgery for remnant gastric cancer: a comparison with open surgery. Surg Endosc 28(8):2452–2458

    Article  Google Scholar 

  2. Takeno S, Hashimoto T, Maki K, Shibata R, Shiwaku H, Yamana I et al (2014) Gastric cancer arising from the remnant stomach after distal gastrectomy: a review. World J Gastroenterol 20(38):13734–13740

    Article  Google Scholar 

  3. Lee SB, Kim JH, Kim DH, Jeon TY, Kim DH, Kim GH et al (2010) Clinicopathological characteristics and prognosis of remnant gastric cancer. J Gastric Cancer 10(4):219–225

    Article  Google Scholar 

  4. Kodera Y, Yamamura Y, Torii A, Uesaka K, Hirai T, Yasui K et al (1996) Gastric remnant carcinoma after partial gastrectomy for benign and malignant gastric lesions. J Am Coll Surg 182(1):1–6

    CAS  PubMed  Google Scholar 

  5. Ohira M, Toyokawa T, Sakurai K, Kubo N, Tanaka H, Muguruma K et al (2016) Current status in remnant gastric cancer after distal gastrectomy. World J Gastroenterol 22(8):2424–2433

    Article  CAS  Google Scholar 

  6. Jeong O, Park YK (2011) Clinicopathological features and surgical treatment of gastric cancer in South Korea: the results of 2009 nationwide survey on surgically treated gastric cancer patients. J Gastric Cancer 11(2):69–77

    Article  Google Scholar 

  7. Shimada H, Fukagawa T, Haga Y, Oba K (2016) Does remnant gastric cancer really differ from primary gastric cancer? A systematic review of the literature by the Task Force of Japanese Gastric Cancer Association. Gastric Cancer 19(2):339–349

    Article  Google Scholar 

  8. Pointner R, Schwab G, Konigsrainer A, Bodner E, Schmid KW (1988) Early cancer of the gastric remnant. Gut 29(3):298–301

    Article  CAS  Google Scholar 

  9. Kwon IG, Cho I, Choi YY, Hyung WJ, Kim CB, Noh SH (2015) Risk factors for complications during surgical treatment of remnant gastric cancer. Gastric Cancer 18(2):390–396

    Article  Google Scholar 

  10. Liao G, Wen S, Xie X, Wu Q (2016) Laparoscopic gastrectomy for remnant gastric cancer: risk factors associated with conversion and a systematic analysis of literature. Int J Surg 34:17–22

    Article  Google Scholar 

  11. Nagai E, Nakata K, Ohuchida K, Miyasaka Y, Shimizu S, Tanaka M (2014) Laparoscopic total gastrectomy for remnant gastric cancer: feasibility study. Surg Endosc 28(1):289–296

    Article  Google Scholar 

  12. Son SY, Lee CM, Jung DH, Lee JH, Ahn SH, Park DJ et al (2015) Laparoscopic completion total gastrectomy for remnant gastric cancer: a single-institution experience. Gastric Cancer 18(1):177–182

    Article  Google Scholar 

  13. Tsunoda S, Okabe H, Tanaka E, Hisamori S, Harigai M, Murakami K et al (2016) Laparoscopic gastrectomy for remnant gastric cancer: a comprehensive review and case series. Gastric Cancer 19(1):287–292

    Article  Google Scholar 

  14. Cho HJ, Kim W, Hur H, Jeon HM (2009) Laparoscopy-assisted completion total gastrectomy for gastric cancer in remnant stomach: report of 2 cases. Surg Laparosc Endosc Percutan Tech 19(2):e57–e60

    Article  Google Scholar 

  15. Qian F, Yu PW, Hao YX, Sun G, Tang B, Shi Y et al (2010) Laparoscopy-assisted resection for gastric stump cancer and gastric stump recurrent cancer: a report of 15 cases. Surg Endosc 24(12):3205–3209

    Article  Google Scholar 

  16. Asbun HJ, Stauffer JA (2012) Laparoscopic vs open pancreaticoduodenectomy: overall outcomes and severity of complications using the Accordion Severity Grading System. J Am Coll Surg 215(6):810–819

    Article  Google Scholar 

  17. Chalikonda S, Aguilar-Saavedra JR, Walsh RM (2012) Laparoscopic robotic-assisted pancreaticoduodenectomy: a case-matched comparison with open resection. Surg Endosc 26(9):2397–2402

    Article  CAS  Google Scholar 

  18. van de Wall BJ, Draaisma WA, Schouten ES, Broeders IA, Consten EC (2010) Conventional and laparoscopic reversal of the Hartmann procedure: a review of literature. J Gastrointest Surg 14(4):743–752

    Article  Google Scholar 

  19. Glantzounis G, Ziogas D, Baltogiannis G (2010) Open versus laparoscopic versus robotic gastrectomy for cancer: need for comparative-effectiveness quality. Surg Endosc 24(6):1510–1512

    Article  CAS  Google Scholar 

  20. Hanisch E, Ziogas D (2010) Robotic versus laparoscopic gastrectomy. Surg Endosc 24(1):239–241 author reply 42-3

    Article  Google Scholar 

  21. Hyun MH, Lee CH, Kwon YJ, Cho SI, Jang YJ, Kim DH et al (2013) Robot versus laparoscopic gastrectomy for cancer by an experienced surgeon: comparisons of surgery, complications, and surgical stress. Ann Surg Oncol 20(4):1258–1265

    Article  Google Scholar 

  22. Junfeng Z, Yan S, Bo T, Yingxue H, Dongzhu Z, Yongliang Z et al (2014) Robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: comparison of surgical performance and short-term outcomes. Surg Endosc 28(6):1779–1787

    Article  Google Scholar 

  23. Kang BH, Xuan Y, Hur H, Ahn CW, Cho YK, Han SU (2012) Comparison of surgical outcomes between robotic and laparoscopic gastrectomy for gastric cancer: the learning curve of robotic surgery. J Gastric Cancer 12(3):156–163

    Article  Google Scholar 

  24. Kim HI, Han SU, Yang HK, Kim YW, Lee HJ, Ryu KW et al (2016) Multicenter prospective comparative study of robotic versus laparoscopic gastrectomy for gastric adenocarcinoma. Ann Surg 263(1):103–109

    Article  Google Scholar 

  25. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  Google Scholar 

  26. Lee HW, Kim HI, An JY, Cheong JH, Lee KY, Hyung WJ et al (2011) Intracorporeal anastomosis using linear stapler in laparoscopic distal gastrectomy: comparison between gastroduodenostomy and gastrojejunostomy. J Gastric Cancer 11(4):212–218

    Article  Google Scholar 

  27. Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH (2009) Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc 23(6):1204–1211

    Article  Google Scholar 

  28. Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH (2009) Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg 249(6):927–932

    Article  Google Scholar 

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Acknowledgements

We would like to thank Anthony Thomas Milliken, ELS (Editing Synthase, Seoul, Korea) for his assistance with editing the manuscript. We also acknowledge the assistance of BioScience Writers, LLC (Houston, TX, USA) with copyediting and correction of English language usage.

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Authors and Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Rana M. Alhossaini, Abdulaziz A. Altamran, Minah Cho, Chul Kyu Roh, Won Jun Seo, Seohee Choi, Taeil Son, Hyoung-Il Kim & Woo Jin Hyung

  2. Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea

    Rana M. Alhossaini, Abdulaziz A. Altamran, Minah Cho, Chul Kyu Roh, Won Jun Seo, Seohee Choi, Taeil Son, Hyoung-Il Kim & Woo Jin Hyung

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  1. Rana M. Alhossaini
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  2. Abdulaziz A. Altamran
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  3. Minah Cho
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  4. Chul Kyu Roh
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  8. Hyoung-Il Kim
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Corresponding author

Correspondence to Woo Jin Hyung.

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Disclosures

Dr. Woo Jin Hyung is a consultant for Ethicon and Verb Surgical, and has stock in Hutom. Drs. Rana M. Alhossaini, Abdulaziz A. Altamran, Minah Cho, Chul Kyu Roh, Won Jun Seo, Seohee Choi, Taeil Son, and Hyoung-Il Kim have no conflicts of interest or financial ties to disclose.

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Alhossaini, R.M., Altamran, A.A., Cho, M. et al. Lower rate of conversion using robotic-assisted surgery compared to laparoscopy in completion total gastrectomy for remnant gastric cancer. Surg Endosc 34, 847–852 (2020). https://doi.org/10.1007/s00464-019-06838-3

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  • DOI: https://doi.org/10.1007/s00464-019-06838-3

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