Robotic Versus Laparoscopic Gastrectomy for Locally Advanced Gastric Cancer

: Robotic gastrectomy (RG) has progressed rapidly in the last decade, overcoming many obstacles in laparoscopic technology. We compared surgical performance and short-term clinical outcomes between RG and laparoscopic gastrectomy (LG). In total, 163 patients with gastric cancer were randomly treated with RG (n=102) or LG (n=61). D2 lymphadenectomy was achieved in all patients. Digestive tract reconstruction in the RG group was performed by intracorporeal hand sewing, but extracorporeal anastomosis in the LG group was performed with a 25-mm circular stapler or linear stapler. Compared with the LG group, the RG group had less intraoperative blood loss (P=0.005) and more lymph nodes retrieved (P=0.000). Postoperative complications between the 2 groups were not significantly different during the 11-month follow-up (P=0.063). Compared with LG, RG is a feasible and safe approach with minimally invasive, satisfactory intracorporeal digestive tract reconstruction, and fast recovery. Multicenter randomized controlled studies of larger numbers of patients are needed.