This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Systematic review and meta‐analysis of robotic surgery compared with conventional laparoscopic and open resections for gastric carcinoma. BJS 2013; 100: 1566-1578.

Published: 9th October 2013

Authors: M.‐H. Hyun, C.‐H. Lee, H.‐J. Kim, Y. Tong, S.‐S. Park

Background

Robot‐assisted gastrectomy (RAG) has been developed in the hope of improving surgical quality and overcoming the limitations of conventional laparoscopically assisted gastrectomy (LAG) and open gastrectomy (OG) for gastric cancer. The aim of this study was to determine the extent of evidence in support of these ideals.

Method

A systematic review of the three operation types (RAG, LAG and OG) was carried out to evaluate short‐term outcomes including duration of operation, retrieved lymph nodes, estimated blood loss, resection margin status, technical postoperative complications and hospital stay.

Results

Nine non‐randomized observational clinical studies involving 7200 patients satisfied the eligibility criteria. RAG was associated with longer operating times than LAG and OG (weighted mean difference 61·99 and 65·73 min respectively; P ≤ 0·001). The number of retrieved lymph nodes and the resection margin length in RAG were comparable with those of LAG and OG. Estimated blood loss was significantly less in RAG than in OG (P = 0·002), but not LAG. Mean hospital stay for RAG was similar to that for LAG (P = 0·14). In contrast, hospital stay was significantly shorter, by a mean of 2·18 days, for RAG compared with OG (P < 0·001). Postoperative complications were similar for all three operative approaches.

Conclusion

Short‐term oncological outcomes of RAG were comparable with those of the other approaches. LAG was a shorter procedure and less expensive than RAG. Future studies involving RAG should focus on minimizing duration of operation and reducing cost.

Full text

You may also be interested in

Randomized clinical trial

Randomized clinical trial of extensive intraoperative peritoneal lavage versus standard treatment for resectable advanced gastric cancer (CCOG 1102 trial).

Authors: K. Misawa, Y. Mochizuki, M. Sakai, H. Teramoto, D. Morimoto, H. Nakayama et al.

Randomized clinical trial

Long‐term follow‐up of two randomized trials comparing laparoscopic Nissen 360° with anterior 90° partial fundoplication.

Authors: R. J. Hopkins, T. Irvine, G. G. Jamieson, P. G. Devitt, D. I. Watson

Randomized clinical trial

Health‐related quality of life in a randomized trial of neoadjuvant chemotherapy or chemoradiotherapy plus surgery in patients with oesophageal cancer (NeoRes trial). BJS 2019; 106: 1452-1463.

Authors: B. Sunde, F. Klevebro, A. Johar, G. Johnsen, A.‐B. Jacobsen, N. I. Glenjen et al.

Original article

Morphological lymphocytic reaction, patient prognosis and PD‐1 expression after surgical resection for oesophageal cancer. BJS 2019; 106: 1352-1361.

Authors: Y. Baba, T. Yagi, K. Kosumi, K. Okadome, D. Nomoto, K. Eto et al.

Original article

Quality of life from a randomized trial of laparoscopic or open liver resection for colorectal liver metastases. BJS 2019; 106: 1372-1380.

Authors: Å. A. Fretland, V. J. Dagenborg, G. M. Waaler Bjørnelv, D. L. Aghayan, A. M. Kazaryan, L. Barkhatov et al.

Original article

Effect of neoadjuvant chemoradiation on preoperative pulmonary physiology, postoperative respiratory complications and quality of life in patients with oesophageal cancer. BJS 2019; 106: 1341-1351.

Authors: J. A. Elliott, L. O'Byrne, G. Foley, C. F. Murphy, S. L. Doyle, S. King et al.

Original article

Quality assurance of surgery in the randomized ST03 trial of perioperative chemotherapy in carcinoma of the stomach and gastro‐oesophageal junction.

Authors: W. H. Allum, E. C. Smyth, J. M. Blazeby, H. I. Grabsch, S. M. Griffin, S. Rowley et al.

Systematic review

Meta‐analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis. BJS 2019; 106: 1442-1451.

Authors: N. Moody, A. Adiamah, F. Yanni, D. Gomez

Article

Development and validation of a staging system for gastric adenocarcinoma after neoadjuvant chemotherapy and gastrectomy with D2 lymphadenectomy.

Authors: J. X. Lin, C. Yoon, J. Desiderio, B. C. Yi, P. Li, C. H. Zheng et al.

Systematic review and meta‐analysis of robotic surgery compared with conventional laparoscopic and open resections for gastric carcinoma. BJS 2013; 100: 1566-1578.

Background

Method

Results

Conclusion

You may also be interested in

Randomized clinical trial of extensive intraoperative peritoneal lavage versus standard treatment for resectable advanced gastric cancer (CCOG 1102 trial).

Long‐term follow‐up of two randomized trials comparing laparoscopic Nissen 360° with anterior 90° partial fundoplication.

Health‐related quality of life in a randomized trial of neoadjuvant chemotherapy or chemoradiotherapy plus surgery in patients with oesophageal cancer (NeoRes trial). BJS 2019; 106: 1452-1463.

Morphological lymphocytic reaction, patient prognosis and PD‐1 expression after surgical resection for oesophageal cancer. BJS 2019; 106: 1352-1361.

Quality of life from a randomized trial of laparoscopic or open liver resection for colorectal liver metastases. BJS 2019; 106: 1372-1380.

Effect of neoadjuvant chemoradiation on preoperative pulmonary physiology, postoperative respiratory complications and quality of life in patients with oesophageal cancer. BJS 2019; 106: 1341-1351.

Quality assurance of surgery in the randomized ST03 trial of perioperative chemotherapy in carcinoma of the stomach and gastro‐oesophageal junction.

Meta‐analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis. BJS 2019; 106: 1442-1451.

Screening for gastric cancer using exhaled breath samples.

Bile acid changes after metabolic surgery are linked to improvement in insulin sensitivity.

Routine chest CT for staging of gastric cancer.

Development and validation of a staging system for gastric adenocarcinoma after neoadjuvant chemotherapy and gastrectomy with D2 lymphadenectomy.