Our Summary

This study compared two types of minimally invasive surgeries used to treat stomach cancer: laparoscopic-assisted (LA) and robotic-assisted (RA) gastrectomies. The data came from the National Cancer Database and included adult patients with stages I to III stomach cancer. The two groups of patients were similar in regards to their cancer stages, additional treatments, demographics, and the extent of their surgeries.

The research found that both types of surgery had similar results in terms of the rate of successful removal of all visible cancer (negative margin rate) and the number of patients who died within 30 and 90 days after surgery. Patients’ survival rates over the long term were also similar, with median survival times of 49.2 months for LA and 56.2 months for RA.

However, the robotic surgery was more effective in one aspect: it allowed doctors to remove and examine more lymph nodes, which helps them determine the stage of the cancer more accurately. The average number of lymph nodes sampled was 19.6 with RA compared to 17.4 with LA. Also, a higher percentage of RA surgeries resulted in 15 or more lymph nodes being examined (63.9% for RA vs 57.6% for LA). The study also found that examining 15 or more lymph nodes was associated with better survival rates.

In conclusion, the study suggests that robotic surgery may be better than laparoscopic surgery for stomach cancer in terms of collecting more lymph nodes for examination, without increasing short-term risks. The survival outcomes for both types of surgery appear to be similar.

FAQs

  1. What were the main findings of this study comparing laparoscopic and robotic surgeries for stomach cancer?
  2. How do the survival rates compare between patients who underwent laparoscopic surgery and those who underwent robotic surgery?
  3. Why is the ability to remove and examine more lymph nodes during surgery important in the treatment of stomach cancer?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastrectomy is to discuss with their healthcare team the benefits and risks of different types of minimally invasive surgeries, such as laparoscopic-assisted and robotic-assisted gastrectomies. It is important to understand that robotic surgery may allow for the examination of more lymph nodes, which can help determine the stage of the cancer more accurately and potentially lead to better long-term survival outcomes. Patients should have a conversation with their surgeon about the best surgical approach for their individual case.

Suitable For

Patients who are typically recommended for gastrectomy include those with stages I to III stomach cancer. This study specifically looked at adult patients with stomach cancer in these stages. It is important for patients to discuss with their healthcare provider to determine the best treatment option for their specific case.

Timeline

Before gastrectomy:

  1. Patient is diagnosed with stomach cancer and undergoes various tests and consultations to determine the stage and extent of the cancer.
  2. Patient discusses treatment options with their healthcare team, including the possibility of surgery.
  3. Patient undergoes preoperative preparations, which may include dietary restrictions, lifestyle changes, and medical evaluations.
  4. Patient undergoes the gastrectomy surgery, either laparoscopic-assisted or robotic-assisted.
  5. Recovery period post-surgery, which may involve hospitalization, pain management, and monitoring for complications.

After gastrectomy:

  1. Patient begins the recovery process, which includes gradually reintroducing food and adjusting to the changes in digestion.
  2. Patient may undergo additional treatments such as chemotherapy or radiation therapy to target any remaining cancer cells.
  3. Patient attends follow-up appointments with their healthcare team to monitor their progress and address any concerns.
  4. Patient may experience long-term side effects such as changes in diet, digestion, and lifestyle.
  5. Patient continues to be monitored for recurrence of cancer and undergoes routine screenings and tests to ensure their health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about gastrectomy include:

  1. What are the differences between laparoscopic-assisted and robotic-assisted gastrectomies?
  2. How will the type of surgery I have affect the number of lymph nodes that can be examined?
  3. What are the short-term risks associated with both types of surgery?
  4. How will the type of surgery I have impact my long-term survival outcomes?
  5. What is the average recovery time for each type of surgery?
  6. Are there any specific factors about my case that make one type of surgery more suitable for me than the other?
  7. How experienced is the surgical team in performing the specific type of gastrectomy recommended for me?
  8. Are there any alternative treatment options to consider besides surgery?
  9. What is the follow-up care plan after surgery?
  10. How will my diet and lifestyle need to change after gastrectomy surgery?

Reference

Authors: Ryan S, Tameron A, Murphy A, Hussain L, Dunki-Jacobs E, Lee DY. Journal: Surg Innov. 2020 Feb;27(1):26-31. doi: 10.1177/1553350619868113. Epub 2019 Aug 23. PMID: 31441711