Reduced-ports Robotic Pylorus-preserving Gastrectomy with Intracorporeal Gastro-gastrostomy for Early Gastric Cancer
EAES Academy. Kang S. 07/05/22; 363140; P185
Dr. So Hyun Kang
Contributions
Contributions
Abstract
Background:
Laparoscopic gastrectomy has proven to be safe and effective as first-line treatment for early gastric cancer (EGC) in terms of oncologic results. Although there still are controversies regarding the role of robotic gastrectomy for EGC, the robotic system offers stable 3D vision, near-infrared fluorescence imaging, and articulating wrist movements. These advantages make the robotic system suitable in performing reduced-ports robotic pylorus-preserving gastrectomy (RP-RPPG) with intracorporeal gastro-gastrostomy, which is a technically demanding operation. This study looks on the feasibility and safety of RP-RPPG for EGC.
Materials and Methods
Patients who underwent RP-RPPG at a single institution from March 2019 to November 2021 were enrolled. Electronic medical records were retrospectively reviewed for operative time, estimated blood loss (EBL), retrieved number of lymph nodes, postoperative hospital course, and early complications.
Results:
RP-RPPG was performed on 65 patients with mean age of 57.2 ± 11.2 years and a body mass index of 23.4 ± 3.1 kg/m2. Three abdominal incisions were made, and a single-port device was inserted into the umbilical wound. There was no case of additional trocar insertion. The mean operative time was 187.4 ± 54.3 mins., EBL was 31.1 ± 49.5 ml, and retrieved number of lymph nodes was 45.8 ± 14.3. In the final pathological stage, 57 (87.7%) were pT1, 6 (9.2%) were pT2, and 2 (3.1%) were pT4a. For N stage, 60 (93.8%) patients were node negative, and 4 (6.2%) patients were diagnosed pN1. The median postoperative day to first flatus was 3 days (range ), to first soft fluid diet was 2 days (range ), and the median postoperative hospital stay was 5 days (range ). Four (6.2%) patients had early complication – two had unknown fever controlled with antibiotics, and other two had delayed gastric emptying which recovered within 3 days. There was no case of mortality.
Conclusion:
RP-RPPG can be performed safely without increasing early postoperative morbidity.
Laparoscopic gastrectomy has proven to be safe and effective as first-line treatment for early gastric cancer (EGC) in terms of oncologic results. Although there still are controversies regarding the role of robotic gastrectomy for EGC, the robotic system offers stable 3D vision, near-infrared fluorescence imaging, and articulating wrist movements. These advantages make the robotic system suitable in performing reduced-ports robotic pylorus-preserving gastrectomy (RP-RPPG) with intracorporeal gastro-gastrostomy, which is a technically demanding operation. This study looks on the feasibility and safety of RP-RPPG for EGC.
Materials and Methods
Patients who underwent RP-RPPG at a single institution from March 2019 to November 2021 were enrolled. Electronic medical records were retrospectively reviewed for operative time, estimated blood loss (EBL), retrieved number of lymph nodes, postoperative hospital course, and early complications.
Results:
RP-RPPG was performed on 65 patients with mean age of 57.2 ± 11.2 years and a body mass index of 23.4 ± 3.1 kg/m2. Three abdominal incisions were made, and a single-port device was inserted into the umbilical wound. There was no case of additional trocar insertion. The mean operative time was 187.4 ± 54.3 mins., EBL was 31.1 ± 49.5 ml, and retrieved number of lymph nodes was 45.8 ± 14.3. In the final pathological stage, 57 (87.7%) were pT1, 6 (9.2%) were pT2, and 2 (3.1%) were pT4a. For N stage, 60 (93.8%) patients were node negative, and 4 (6.2%) patients were diagnosed pN1. The median postoperative day to first flatus was 3 days (range ), to first soft fluid diet was 2 days (range ), and the median postoperative hospital stay was 5 days (range ). Four (6.2%) patients had early complication – two had unknown fever controlled with antibiotics, and other two had delayed gastric emptying which recovered within 3 days. There was no case of mortality.
Conclusion:
RP-RPPG can be performed safely without increasing early postoperative morbidity.
Background:
Laparoscopic gastrectomy has proven to be safe and effective as first-line treatment for early gastric cancer (EGC) in terms of oncologic results. Although there still are controversies regarding the role of robotic gastrectomy for EGC, the robotic system offers stable 3D vision, near-infrared fluorescence imaging, and articulating wrist movements. These advantages make the robotic system suitable in performing reduced-ports robotic pylorus-preserving gastrectomy (RP-RPPG) with intracorporeal gastro-gastrostomy, which is a technically demanding operation. This study looks on the feasibility and safety of RP-RPPG for EGC.
Materials and Methods
Patients who underwent RP-RPPG at a single institution from March 2019 to November 2021 were enrolled. Electronic medical records were retrospectively reviewed for operative time, estimated blood loss (EBL), retrieved number of lymph nodes, postoperative hospital course, and early complications.
Results:
RP-RPPG was performed on 65 patients with mean age of 57.2 ± 11.2 years and a body mass index of 23.4 ± 3.1 kg/m2. Three abdominal incisions were made, and a single-port device was inserted into the umbilical wound. There was no case of additional trocar insertion. The mean operative time was 187.4 ± 54.3 mins., EBL was 31.1 ± 49.5 ml, and retrieved number of lymph nodes was 45.8 ± 14.3. In the final pathological stage, 57 (87.7%) were pT1, 6 (9.2%) were pT2, and 2 (3.1%) were pT4a. For N stage, 60 (93.8%) patients were node negative, and 4 (6.2%) patients were diagnosed pN1. The median postoperative day to first flatus was 3 days (range ), to first soft fluid diet was 2 days (range ), and the median postoperative hospital stay was 5 days (range ). Four (6.2%) patients had early complication – two had unknown fever controlled with antibiotics, and other two had delayed gastric emptying which recovered within 3 days. There was no case of mortality.
Conclusion:
RP-RPPG can be performed safely without increasing early postoperative morbidity.
Laparoscopic gastrectomy has proven to be safe and effective as first-line treatment for early gastric cancer (EGC) in terms of oncologic results. Although there still are controversies regarding the role of robotic gastrectomy for EGC, the robotic system offers stable 3D vision, near-infrared fluorescence imaging, and articulating wrist movements. These advantages make the robotic system suitable in performing reduced-ports robotic pylorus-preserving gastrectomy (RP-RPPG) with intracorporeal gastro-gastrostomy, which is a technically demanding operation. This study looks on the feasibility and safety of RP-RPPG for EGC.
Materials and Methods
Patients who underwent RP-RPPG at a single institution from March 2019 to November 2021 were enrolled. Electronic medical records were retrospectively reviewed for operative time, estimated blood loss (EBL), retrieved number of lymph nodes, postoperative hospital course, and early complications.
Results:
RP-RPPG was performed on 65 patients with mean age of 57.2 ± 11.2 years and a body mass index of 23.4 ± 3.1 kg/m2. Three abdominal incisions were made, and a single-port device was inserted into the umbilical wound. There was no case of additional trocar insertion. The mean operative time was 187.4 ± 54.3 mins., EBL was 31.1 ± 49.5 ml, and retrieved number of lymph nodes was 45.8 ± 14.3. In the final pathological stage, 57 (87.7%) were pT1, 6 (9.2%) were pT2, and 2 (3.1%) were pT4a. For N stage, 60 (93.8%) patients were node negative, and 4 (6.2%) patients were diagnosed pN1. The median postoperative day to first flatus was 3 days (range ), to first soft fluid diet was 2 days (range ), and the median postoperative hospital stay was 5 days (range ). Four (6.2%) patients had early complication – two had unknown fever controlled with antibiotics, and other two had delayed gastric emptying which recovered within 3 days. There was no case of mortality.
Conclusion:
RP-RPPG can be performed safely without increasing early postoperative morbidity.
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