Narrative Review On Robotic Gastrectomy D2 For Gastric Cancer

Danilo Coco; Silvana Leanza

doi:10.34635/rpc.1048

Danilo Coco Department of General Surgery, Giglio hospital, Cefalu, Italy
Silvana Leanza Department of General Surgery, Giglio hospital, Cefalu, Italy

Abstract

Background: Gastric cancer remains a significant global health burden, with limited treatment options. Robotic-assisted gastrectomy (RAG) has emerged as a promising surgical approach for the management of gastric cancer. This comprehensive review aims to evaluate the current evidence on the clinical outcomes and safety profiles of RAG with D2 lymphadenectomy for the treatment of gastric cancer.

Methods: A systematic literature search was conducted following the PRISMA guidelines. Electronic databases, including PubMed, Embase, and Cochrane Library, were searched for relevant studies published from inception to May 2023. The search terms included “robotic gastrectomy,” “gastric cancer,” and “D2 lymphadenectomy.” Studies reporting on the perioperative, oncological, and long-term outcomes of RAG with D2 lymphadenectomy were included. Risk of bias assessment and meta-analysis were performed using appropriate statistical methods.

Results: A total of 34 studies, including 8,423 patients, were included in the review. The pooled analysis demonstrated that RAG with D2 lymphadenectomy was associated with comparable postoperative outcomes, including operative time, blood loss, and length of hospital stay, when compared to open or laparoscopic gastrectomy with D2 lymphadenectomy. RAG also showed similar rates of postoperative complications, 30-day mortality, and oncological outcomes, such as lymph node retrieval and R0 resection rates. Long-term survival analysis revealed comparable 3-year and 5-year overall survival rates between RAG and other surgical approaches.

Conclusion: Robotic-assisted gastrectomy with D2 lymphadenectomy appears to be a safe and effective surgical approach for the treatment of gastric cancer, with comparable perioperative and oncological outcomes to conventional open or laparoscopic techniques. The adoption of robotic technology may provide additional benefits, such as improved visualization and dexterity, which may contribute to the optimal surgical management of gastric cancer. Further large-scale, high-quality studies are warranted to validate the long-term outcomes of this emerging surgical approach.

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