Advantages of a robotic approach compared with laparoscopy gastrectomy for patients with high visceral fat area
Background Gastric cancer surgery for obese patients is regarded as a technically challenging procedure. The morbidity after gastrectomy has been reported to be significantly higher in patients with high visceral fat area (VFA). Robotic gastrectomy (RG) is expected to be advantageous for complicated...
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| Veröffentlicht in: | Surgical endoscopy 2022-08, Vol.36 (8), p.6181-6193 |
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| creator | Hikage, Makoto Fujiya, Keiichi Waki, Yuhei Kamiya, Satoshi Tanizawa, Yutaka Bando, Etsuro Notsu, Akifumi Terashima, Masanori |
| description | Background
Gastric cancer surgery for obese patients is regarded as a technically challenging procedure. The morbidity after gastrectomy has been reported to be significantly higher in patients with high visceral fat area (VFA). Robotic gastrectomy (RG) is expected to be advantageous for complicated operations. However, whether RG is superior to conventional laparoscopic gastrectomy (LG) for patients with visceral fat obesity remains unclear. The present study aimed to clarify the impact of RG on the short- and long-term outcomes of patients with high VFAs.
Methods
This study included 1306 patients with clinical stage I/II gastric cancer who underwent minimally invasive gastrectomy between January 2012 and December 2020. The patients were subclassified according to VFA. The short- and long-term outcomes of RG were compared with those of LG in two VFA categories.
Results
This study included 394 (high-VFA, 151; low-VFA, 243) and 882 patients (high-VFA, 366; low-VFA, 516) in the RG and LG groups, respectively. RG was associated with a significantly longer operative time than LG (high-VFA,
P
|
| doi_str_mv | 10.1007/s00464-022-09178-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2640324150</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2689393133</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-6743f412797e0a9e6de4ba6d85ea31e8cffadc58e809019312076b7b672364083</originalsourceid><addsrcrecordid>eNp9kU9v1DAQxS0EotvCF-CALHHhEhj_SRwfqwooUiUucLYmzmQ3VRIH21u63x6XFJA4cLJG_s2bN_MYeyXgnQAw7xOAbnQFUlZghWmr-ydsJ7SSlZSifcp2YBVU0lh9xs5TuoXCW1E_Z2eqllY3Su9YuOzvcMm4p8TDwJHH0IU8eo7rGgP6A_dhXjFSz3-M-cAnLEVIPqwnvseUI_kc5hMfQuQr5pGWnDbyMO4P_G5MniJOfMDMiwq-YM8GnBK9fHwv2LePH75eXVc3Xz59vrq8qbwyda4ao9WgRfFuCNBS05PusOnbmlAJav0wYO_rllqwIKwSEkzTma4xUjUaWnXB3m66ZYvvR0rZzQ9WpgkXCsfkZKGU1KKGgr75B70Nx7gUd4VqrSrqShVKbpQv66dIg1vjOGM8OQHuIQ63xeFKHO5XHO6-NL1-lD52M_V_Wn7fvwBqA1L5WvYU_87-j-xPqL2Wig</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2689393133</pqid></control><display><type>article</type><title>Advantages of a robotic approach compared with laparoscopy gastrectomy for patients with high visceral fat area</title><source>SpringerLink Journals</source><creator>Hikage, Makoto ; Fujiya, Keiichi ; Waki, Yuhei ; Kamiya, Satoshi ; Tanizawa, Yutaka ; Bando, Etsuro ; Notsu, Akifumi ; Terashima, Masanori</creator><creatorcontrib>Hikage, Makoto ; Fujiya, Keiichi ; Waki, Yuhei ; Kamiya, Satoshi ; Tanizawa, Yutaka ; Bando, Etsuro ; Notsu, Akifumi ; Terashima, Masanori</creatorcontrib><description>Background
Gastric cancer surgery for obese patients is regarded as a technically challenging procedure. The morbidity after gastrectomy has been reported to be significantly higher in patients with high visceral fat area (VFA). Robotic gastrectomy (RG) is expected to be advantageous for complicated operations. However, whether RG is superior to conventional laparoscopic gastrectomy (LG) for patients with visceral fat obesity remains unclear. The present study aimed to clarify the impact of RG on the short- and long-term outcomes of patients with high VFAs.
Methods
This study included 1306 patients with clinical stage I/II gastric cancer who underwent minimally invasive gastrectomy between January 2012 and December 2020. The patients were subclassified according to VFA. The short- and long-term outcomes of RG were compared with those of LG in two VFA categories.
Results
This study included 394 (high-VFA, 151; low-VFA, 243) and 882 patients (high-VFA, 366; low-VFA, 516) in the RG and LG groups, respectively. RG was associated with a significantly longer operative time than LG (high-VFA,
P
< 0.001; low-VFA,
P
< 0.001). The incidence rates of overall and intra-abdominal infectious complications in the high-VFA patients were lower in the RG group than in the LG group (
P
= 0.019 and
P
= 0.048, respectively) but not significantly different from those in the low-VFA patients. In the multivariate analysis, LG was identified as the only independent risk factor of overall (odds ratio [OR] 3.281;
P
= 0.012) and intra-abdominal infectious complications (OR 3.462;
P
= 0.021) in the high-VFA patients. The overall survival of high-VFA patients was significantly better in the RG group than in the LG group (
P
= 0.045).
Conclusions
For patients with visceral fat obesity, RG appears to be advantageous to LG in terms of reducing the risk of complications and better long-term survival.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-022-09178-x</identifier><identifier>PMID: 35294634</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdomen ; Abdominal Surgery ; Cancer surgery ; Clinical trials ; Endoscopy ; Gastric cancer ; Gastroenterology ; Gastrointestinal surgery ; Gynecology ; Hepatology ; Insurance coverage ; Laparoscopy ; Medicine ; Medicine & Public Health ; Obesity ; Pancreas ; Patients ; Proctology ; Robotics ; Surgeons ; Surgery ; Surgical outcomes</subject><ispartof>Surgical endoscopy, 2022-08, Vol.36 (8), p.6181-6193</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-6743f412797e0a9e6de4ba6d85ea31e8cffadc58e809019312076b7b672364083</citedby><cites>FETCH-LOGICAL-c375t-6743f412797e0a9e6de4ba6d85ea31e8cffadc58e809019312076b7b672364083</cites><orcidid>0000-0002-2967-8267</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-022-09178-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-022-09178-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35294634$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hikage, Makoto</creatorcontrib><creatorcontrib>Fujiya, Keiichi</creatorcontrib><creatorcontrib>Waki, Yuhei</creatorcontrib><creatorcontrib>Kamiya, Satoshi</creatorcontrib><creatorcontrib>Tanizawa, Yutaka</creatorcontrib><creatorcontrib>Bando, Etsuro</creatorcontrib><creatorcontrib>Notsu, Akifumi</creatorcontrib><creatorcontrib>Terashima, Masanori</creatorcontrib><title>Advantages of a robotic approach compared with laparoscopy gastrectomy for patients with high visceral fat area</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Gastric cancer surgery for obese patients is regarded as a technically challenging procedure. The morbidity after gastrectomy has been reported to be significantly higher in patients with high visceral fat area (VFA). Robotic gastrectomy (RG) is expected to be advantageous for complicated operations. However, whether RG is superior to conventional laparoscopic gastrectomy (LG) for patients with visceral fat obesity remains unclear. The present study aimed to clarify the impact of RG on the short- and long-term outcomes of patients with high VFAs.
Methods
This study included 1306 patients with clinical stage I/II gastric cancer who underwent minimally invasive gastrectomy between January 2012 and December 2020. The patients were subclassified according to VFA. The short- and long-term outcomes of RG were compared with those of LG in two VFA categories.
Results
This study included 394 (high-VFA, 151; low-VFA, 243) and 882 patients (high-VFA, 366; low-VFA, 516) in the RG and LG groups, respectively. RG was associated with a significantly longer operative time than LG (high-VFA,
P
< 0.001; low-VFA,
P
< 0.001). The incidence rates of overall and intra-abdominal infectious complications in the high-VFA patients were lower in the RG group than in the LG group (
P
= 0.019 and
P
= 0.048, respectively) but not significantly different from those in the low-VFA patients. In the multivariate analysis, LG was identified as the only independent risk factor of overall (odds ratio [OR] 3.281;
P
= 0.012) and intra-abdominal infectious complications (OR 3.462;
P
= 0.021) in the high-VFA patients. The overall survival of high-VFA patients was significantly better in the RG group than in the LG group (
P
= 0.045).
Conclusions
For patients with visceral fat obesity, RG appears to be advantageous to LG in terms of reducing the risk of complications and better long-term survival.</description><subject>Abdomen</subject><subject>Abdominal Surgery</subject><subject>Cancer surgery</subject><subject>Clinical trials</subject><subject>Endoscopy</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Insurance coverage</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity</subject><subject>Pancreas</subject><subject>Patients</subject><subject>Proctology</subject><subject>Robotics</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kU9v1DAQxS0EotvCF-CALHHhEhj_SRwfqwooUiUucLYmzmQ3VRIH21u63x6XFJA4cLJG_s2bN_MYeyXgnQAw7xOAbnQFUlZghWmr-ydsJ7SSlZSifcp2YBVU0lh9xs5TuoXCW1E_Z2eqllY3Su9YuOzvcMm4p8TDwJHH0IU8eo7rGgP6A_dhXjFSz3-M-cAnLEVIPqwnvseUI_kc5hMfQuQr5pGWnDbyMO4P_G5MniJOfMDMiwq-YM8GnBK9fHwv2LePH75eXVc3Xz59vrq8qbwyda4ao9WgRfFuCNBS05PusOnbmlAJav0wYO_rllqwIKwSEkzTma4xUjUaWnXB3m66ZYvvR0rZzQ9WpgkXCsfkZKGU1KKGgr75B70Nx7gUd4VqrSrqShVKbpQv66dIg1vjOGM8OQHuIQ63xeFKHO5XHO6-NL1-lD52M_V_Wn7fvwBqA1L5WvYU_87-j-xPqL2Wig</recordid><startdate>20220801</startdate><enddate>20220801</enddate><creator>Hikage, Makoto</creator><creator>Fujiya, Keiichi</creator><creator>Waki, Yuhei</creator><creator>Kamiya, Satoshi</creator><creator>Tanizawa, Yutaka</creator><creator>Bando, Etsuro</creator><creator>Notsu, Akifumi</creator><creator>Terashima, Masanori</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2967-8267</orcidid></search><sort><creationdate>20220801</creationdate><title>Advantages of a robotic approach compared with laparoscopy gastrectomy for patients with high visceral fat area</title><author>Hikage, Makoto ; Fujiya, Keiichi ; Waki, Yuhei ; Kamiya, Satoshi ; Tanizawa, Yutaka ; Bando, Etsuro ; Notsu, Akifumi ; Terashima, Masanori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-6743f412797e0a9e6de4ba6d85ea31e8cffadc58e809019312076b7b672364083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdomen</topic><topic>Abdominal Surgery</topic><topic>Cancer surgery</topic><topic>Clinical trials</topic><topic>Endoscopy</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Insurance coverage</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity</topic><topic>Pancreas</topic><topic>Patients</topic><topic>Proctology</topic><topic>Robotics</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hikage, Makoto</creatorcontrib><creatorcontrib>Fujiya, Keiichi</creatorcontrib><creatorcontrib>Waki, Yuhei</creatorcontrib><creatorcontrib>Kamiya, Satoshi</creatorcontrib><creatorcontrib>Tanizawa, Yutaka</creatorcontrib><creatorcontrib>Bando, Etsuro</creatorcontrib><creatorcontrib>Notsu, Akifumi</creatorcontrib><creatorcontrib>Terashima, Masanori</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hikage, Makoto</au><au>Fujiya, Keiichi</au><au>Waki, Yuhei</au><au>Kamiya, Satoshi</au><au>Tanizawa, Yutaka</au><au>Bando, Etsuro</au><au>Notsu, Akifumi</au><au>Terashima, Masanori</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Advantages of a robotic approach compared with laparoscopy gastrectomy for patients with high visceral fat area</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2022-08-01</date><risdate>2022</risdate><volume>36</volume><issue>8</issue><spage>6181</spage><epage>6193</epage><pages>6181-6193</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Gastric cancer surgery for obese patients is regarded as a technically challenging procedure. The morbidity after gastrectomy has been reported to be significantly higher in patients with high visceral fat area (VFA). Robotic gastrectomy (RG) is expected to be advantageous for complicated operations. However, whether RG is superior to conventional laparoscopic gastrectomy (LG) for patients with visceral fat obesity remains unclear. The present study aimed to clarify the impact of RG on the short- and long-term outcomes of patients with high VFAs.
Methods
This study included 1306 patients with clinical stage I/II gastric cancer who underwent minimally invasive gastrectomy between January 2012 and December 2020. The patients were subclassified according to VFA. The short- and long-term outcomes of RG were compared with those of LG in two VFA categories.
Results
This study included 394 (high-VFA, 151; low-VFA, 243) and 882 patients (high-VFA, 366; low-VFA, 516) in the RG and LG groups, respectively. RG was associated with a significantly longer operative time than LG (high-VFA,
P
< 0.001; low-VFA,
P
< 0.001). The incidence rates of overall and intra-abdominal infectious complications in the high-VFA patients were lower in the RG group than in the LG group (
P
= 0.019 and
P
= 0.048, respectively) but not significantly different from those in the low-VFA patients. In the multivariate analysis, LG was identified as the only independent risk factor of overall (odds ratio [OR] 3.281;
P
= 0.012) and intra-abdominal infectious complications (OR 3.462;
P
= 0.021) in the high-VFA patients. The overall survival of high-VFA patients was significantly better in the RG group than in the LG group (
P
= 0.045).
Conclusions
For patients with visceral fat obesity, RG appears to be advantageous to LG in terms of reducing the risk of complications and better long-term survival.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35294634</pmid><doi>10.1007/s00464-022-09178-x</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-2967-8267</orcidid></addata></record> |
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| language | eng |
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| source | SpringerLink Journals |
| subjects | Abdomen Abdominal Surgery Cancer surgery Clinical trials Endoscopy Gastric cancer Gastroenterology Gastrointestinal surgery Gynecology Hepatology Insurance coverage Laparoscopy Medicine Medicine & Public Health Obesity Pancreas Patients Proctology Robotics Surgeons Surgery Surgical outcomes |
| title | Advantages of a robotic approach compared with laparoscopy gastrectomy for patients with high visceral fat area |
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