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Fluorescence-guided Two-port Robotic Gastrectomy Versus Conventional Laparoscopic Gastrectomy: A Nonrandomized Controlled Trial

OBJECTIVE: To compare the number of retrieved lymph nodes between conventional laparoscopic gastrectomy (CLG) and robotic gastrectomy integrated with fluorescence guidance and a two-port system (integrated robotic gastrectomy, IRG). BACKGROUND: The benefits of robotic surgery over laparoscopic surge...

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Autores principales: Choi, Seohee, Kim, Na Young, Kim, Youn Nam, Park, Sung Hyun, Kim, Ki-Yoon, Cho, Minah, Kim, Yoo Min, Hyung, Woo Jin, Kim, Hyoung-Il
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health, Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513269/
https://www.ncbi.nlm.nih.gov/pubmed/37746613
http://dx.doi.org/10.1097/AS9.0000000000000318
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author Choi, Seohee
Kim, Na Young
Kim, Youn Nam
Park, Sung Hyun
Kim, Ki-Yoon
Cho, Minah
Kim, Yoo Min
Hyung, Woo Jin
Kim, Hyoung-Il
author_facet Choi, Seohee
Kim, Na Young
Kim, Youn Nam
Park, Sung Hyun
Kim, Ki-Yoon
Cho, Minah
Kim, Yoo Min
Hyung, Woo Jin
Kim, Hyoung-Il
author_sort Choi, Seohee
collection PubMed
description OBJECTIVE: To compare the number of retrieved lymph nodes between conventional laparoscopic gastrectomy (CLG) and robotic gastrectomy integrated with fluorescence guidance and a two-port system (integrated robotic gastrectomy, IRG). BACKGROUND: The benefits of robotic surgery over laparoscopic surgery for gastric cancer have not yet been established. Using built-in features of robotic system, further benefit can be provided to the patients with effective lymphadenectomy and enhanced recovery. METHODS: A nonrandomized controlled trial was performed by a single surgeon at single-center, tertiary referral hospital between January 2018 and October 2021. Overall, 140 patients scheduled to undergo minimally invasive subtotal gastrectomy for early gastric cancer were enrolled. The primary endpoint was the number of retrieved lymph nodes. Secondary endpoints were complications, hospital stay, pain score, body image, and operative cost. RESULTS: This study analyzed 124 patients in the per-protocol group (IRG, 64; CLG, 60). The number of retrieved lymph nodes was higher in the IRG group than those in the CLG group (IRG vs CLG; 42.1 ± 17.9 vs 35.1 ± 14.6, P = 0.019). Moreover, other surgical parameters, such as hospital stay (4.1 ± 1.0 vs 5.2 ± 1.8, P < 0.001) and body image scale (better in 4 of the 10 questions), were significantly better in the IRG than in the CLG. CONCLUSIONS: Robotic surgical procedures integrated with fluorescence guidance and a reduced-port system yielded more retrieved lymph nodes. In addition, the IRG group showed better perioperative surgical outcomes, particularly regarding the length of hospital stay and postoperative body image. TRIAL REGISTRATION: NCT03396354
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spelling pubmed-105132692023-09-22 Fluorescence-guided Two-port Robotic Gastrectomy Versus Conventional Laparoscopic Gastrectomy: A Nonrandomized Controlled Trial Choi, Seohee Kim, Na Young Kim, Youn Nam Park, Sung Hyun Kim, Ki-Yoon Cho, Minah Kim, Yoo Min Hyung, Woo Jin Kim, Hyoung-Il Ann Surg Open Original Study OBJECTIVE: To compare the number of retrieved lymph nodes between conventional laparoscopic gastrectomy (CLG) and robotic gastrectomy integrated with fluorescence guidance and a two-port system (integrated robotic gastrectomy, IRG). BACKGROUND: The benefits of robotic surgery over laparoscopic surgery for gastric cancer have not yet been established. Using built-in features of robotic system, further benefit can be provided to the patients with effective lymphadenectomy and enhanced recovery. METHODS: A nonrandomized controlled trial was performed by a single surgeon at single-center, tertiary referral hospital between January 2018 and October 2021. Overall, 140 patients scheduled to undergo minimally invasive subtotal gastrectomy for early gastric cancer were enrolled. The primary endpoint was the number of retrieved lymph nodes. Secondary endpoints were complications, hospital stay, pain score, body image, and operative cost. RESULTS: This study analyzed 124 patients in the per-protocol group (IRG, 64; CLG, 60). The number of retrieved lymph nodes was higher in the IRG group than those in the CLG group (IRG vs CLG; 42.1 ± 17.9 vs 35.1 ± 14.6, P = 0.019). Moreover, other surgical parameters, such as hospital stay (4.1 ± 1.0 vs 5.2 ± 1.8, P < 0.001) and body image scale (better in 4 of the 10 questions), were significantly better in the IRG than in the CLG. CONCLUSIONS: Robotic surgical procedures integrated with fluorescence guidance and a reduced-port system yielded more retrieved lymph nodes. In addition, the IRG group showed better perioperative surgical outcomes, particularly regarding the length of hospital stay and postoperative body image. TRIAL REGISTRATION: NCT03396354 Wolters Kluwer Health, Inc. 2023-07-26 /pmc/articles/PMC10513269/ /pubmed/37746613 http://dx.doi.org/10.1097/AS9.0000000000000318 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Study
Choi, Seohee
Kim, Na Young
Kim, Youn Nam
Park, Sung Hyun
Kim, Ki-Yoon
Cho, Minah
Kim, Yoo Min
Hyung, Woo Jin
Kim, Hyoung-Il
Fluorescence-guided Two-port Robotic Gastrectomy Versus Conventional Laparoscopic Gastrectomy: A Nonrandomized Controlled Trial
title Fluorescence-guided Two-port Robotic Gastrectomy Versus Conventional Laparoscopic Gastrectomy: A Nonrandomized Controlled Trial
title_full Fluorescence-guided Two-port Robotic Gastrectomy Versus Conventional Laparoscopic Gastrectomy: A Nonrandomized Controlled Trial
title_fullStr Fluorescence-guided Two-port Robotic Gastrectomy Versus Conventional Laparoscopic Gastrectomy: A Nonrandomized Controlled Trial
title_full_unstemmed Fluorescence-guided Two-port Robotic Gastrectomy Versus Conventional Laparoscopic Gastrectomy: A Nonrandomized Controlled Trial
title_short Fluorescence-guided Two-port Robotic Gastrectomy Versus Conventional Laparoscopic Gastrectomy: A Nonrandomized Controlled Trial
title_sort fluorescence-guided two-port robotic gastrectomy versus conventional laparoscopic gastrectomy: a nonrandomized controlled trial
topic Original Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513269/
https://www.ncbi.nlm.nih.gov/pubmed/37746613
http://dx.doi.org/10.1097/AS9.0000000000000318
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