Comparative study of the outcomes of robotic versus laparoscopic distal gastrectomy with hand-sewn anastomosis in Billroth-I reconstruction

Total laparoscopic distal gastrectomy hand-sewn anastomosis (LDG-HA) for gastric cancer (GC) is safe and effective. The objectives of our study were to investigate the efficacy and safety of laparoscopic versus robotic distal gastrectomy hand-sewn anastomosis (RDG-HA) in Billroth-I reconstruction. We retrospectively analyzed the clinical data of 95 patients treated with LDG-HA (n = 55) and RDG-HA (n = 40) for GC from 09/2018 to 06/2021. The effects on baseline, pathology, perioperative data, short-term outcomes, long-term outcomes and 5-year oncologic outcomes follow-up were analyzed. The difference between the clinical-pathological characteristics of the two groups was not statistically significant (P > 0.05). The RDG-HA group was associated with a shorter anastomosis time (20.80 min vs. 23.36 min, P = 0.001) but a longer operative time (176.55 vs. 151.86 min, P = 0.003) and a higher cost (97661.66 CNY vs. 71082.63 CNY, P = 0.000). The differences of complications, 5-year follow-up overall survival and disease-free survival rates between the two groups were not statistically significant. RDG-HA is safe and effective with a faster procedure of reconstruction but much more expensive.