New totally intracorporeal reconstructive approach after robotic total gastrectomy: Technical details and short-term outcomes

Table 1 Characteristics of patients

Characteristics
Sex (male/female), no.	31/24
Age (yr)	72.56 ± 10.67
BMI (kg/m2)	24.42 ± 72.56
Comorbidity, n (%)	35 (66.04)
ASA score, n
I	8
II	19
III	28
IV	0
Tumor location, n
Lower third	12
Middle third	30
Upper third	13

Table 2 Operative results

Outcomes
Overall operative time, min	354.21 ± 68.8
Incision for specimen extraction, n
Right McBurney incision	55
length of minilaparotomy, cm	5 (4-6)
Intraoperative blood loss, Ml	126.55 ± 73
Intraoperative morbidity, n	0
Intraoperative Mortality, n	0
Conversion, n	0
Extent of lymphadenectomy, n
D1	0
D1+	5
D2	50

Table 3 Clinical outcomes during hospitalization and complications

Outcomes
Time to peristalsis, d	1 (1-3)1
Time to resume liquid diet, d	2 (2-5)1
Time to resume solid intake, d	3 (3-6)1
Length of hospital stay, d	5 (3-17)1
Postoperative 30-d complications, n	0
Reoperations, n	0
30-d mortality, n	0

¹Values are expressed as median (range).

Table 4 Histopathological data

Outcomes
Diameter of the tumor, cm	4.25 (1-8)1
Proximal margin, cm	6 (2-11)1
Number of harvested lymph nodes, n	35 (15-47)1
TNM staging, n (%)
Stage 0	0
Stage IA	8 (14.55)
Stage IB	9 (16.37)
Stage IIA	12 (21.82)
Stage IIB	11 (20.00)
Stage IIIA	7 (12.72)
Stage IIIB	6 (10.91)
Stage IIIC	2 (3.63)
Stage IV	0
Residual tumor, n
R0	55
R1	0
R2	0

¹Values are expressed as median (range).

Table 5 Literature review on robotic total gastrectomy, overall number of reported cases

	Year	Type	Subject	Country	Institution	Period	No.
Present study	2017	Prospective CS	RTG	Italy	St. Mary’s Hospital of Terni	2014-2016	55
Jiang et al[24]	2015	Retrospective CS	RAG	China	Nanjing University Medical College	2010-2012	65
Kim et al[14]	2012	nonRCT	RAG vs LG vs OG	South Korea	Yonsei University College of Medicine	2005-2010	109
Son et al[15]	2014	nonRCT	RTG vs LTG
						2005-2010	51
Woo et al[11]	2011	nonRCT	RAG vs LG			2005-2009	62
Song et al[7]	2009	Prospective CS	RAG			2005-2007	33
Park et al[20]	2013	Retrospective CS	RAG	South Korea	National Cancer Center	2009-2012	46
Yoon et al[17]	2012	nonRCT	RTG vs LTG
						2009-2011	36
Kang et al[13]	2012	nonRCT	RAG vs LG	South Korea	Ajou University School of Medicine	2008-2011	16
Hur et al[8]	2010	Retrospective CS	RAG			2010	2
Hyun et al[18]	2013	nonRCT	RAG vs LG	South Korea	Korea University Anam Hospital	2009-2010	9
Son et al[15]	2012	nonRCT	RAG vs LG	South Korea	Seoul University Bundang Hospital	2007-2011	1
Junfeng et al[21]	2014	nonRCT	RAG vs LG	China	Third Military Medical University	2010-2013	26
Liu et al[19]	2013	Prospective CS	RAG	China	Subei People's Hospital of Jiangsu	2011-2013	54
Giulianotti et al[25]	2003	Retrospective CS	RAG	Italy	Misericordia Hospital of Grosseto	2000-2002	10
Coratti et al[26]	2015	Retrospective CS	RAG	Italy		2000-2014	38
D'Annibale et al[10]	2011	Retrospective CS	RAG	Italy	S. Giovanni Addolorata Hospital	2004-2009	11
Caruso et al[9]	2011	nonRCT	RAG vs OG	Italy	Hospital of Spoleto	2006-2010	12
Suda et al[23]	2014	nonRCT	RAG vs LG	Japan	Fujita Health University	2009-2012	30
Huang et al[12]	2012	nonRCT	RAG vs LG vs OG	Taiwan	Taipei Veterans General Hospital	2010-2012	7
Vasilescu et al[16]	2012	Retrospective CS	RAG	Romania	Fundeni Clinical Institute	2008-2012	19
Zawadzki et al[27]	2014	CR	RAG	Poland	Wroclaw Medical University	2014	1
Parisi et al[5]	2015	Prospective CS	RTG	Italy	St. Mary’s Hospital of Terni	2014-2015	22
Total1							466

¹Excluding the present study.

Table 6 Literature review on robotic total gastrectomy, details of the reported data

	Robot - Assistance			Type	E-J anastomosis	Anastomosis performance	Site of minilaparotomy	Operative and clinical data	Patients and tumor details
	Lymphadenectomy	Stomach mobilization	Reconstruction
Jiang et al[24]	Performed	Performed		Roux-en-Y	EXTRA	Circular stapler	Not provided	Provided	Provided
			Performed	Roux-en-Y	INTRA	Robot-sewn	Not provided
Kim et al[14]	Not provided	Not provided	Not provided	Roux-en-Y	Not provided	Not provided	Not provided	Lack	Lack
Son et al[15]	Performed	Performed		Roux-en-Y	EXTRA	Circular stapler	Upper midline	Provided	Provided
				Roux-en-Y	INTRA LAP	Circular stapler	Left lower port
Woo et al[11]	Performed	Performed		Roux-en-Y	EXTRA	Not provided	Not provided	Lack	Lack
				Roux-en-Y	INTRA LAP	Not provided	Not provided
Song et al[7]	Performed	Performed		Roux-en-Y	EXTRA	Circular stapler	Upper midline	Lack	Lack
				Roux-en-Y	INTRA LAP	Circular stapler	Not provided
Park et al[20]	Performed	Performed		Roux-en-Y	EXTRA	Not provided	Upper midline	Provided	Lack
Yoon et al[17]	Performed	Performed		Roux-en-Y	EXTRA	Circular stapler	Not provided	Provided	Provided
Kang et al[13]	Performed	Performed		Roux-en-Y	EXTRA	Circular stapler	Upper midline	Lack	Lack
			Performed	Roux-en-Y	INTRA	Robot-sewn	Not provided
Hur et al[8]	Performed	Performed	Performed	Roux-en-Y	INTRA	Robot-sewn	Not provided	Lack	Lack
Hyun et al[18]	Performed	Performed		Roux-en-Y	EXTRA	Circular stapler	Upper midline	Lack	Lack
			Not provided	Roux-en-Y	INTRA	Not provided	Umbilical port
Son et al[15]	Performed	Performed		Roux-en-Y	EXTRA	Not provided	Not provided	Lack	Lack
Junfeng et al[21]	Performed	Performed		Roux-en-Y	EXTRA	Circular stapler	Upper midline	Provided	Provided
Liu et al[19]	Performed	Performed	Performed	Roux-en-Y	INTRA	Robot-sewn	Camera port	Lack	Lack
Giulianotti et al[25]	Performed	Performed	Performed	Roux-en-Y	INTRA	Circular stapler	Not provided	Lack	Lack
Coratti et al[26]	Performed	Performed	Performed	Roux-en-Y	INTRA	Robot-sewn	Not provided	Provided	Provided
D'Annibale et al[10]	Performed	Performed	Performed	Roux-en-Y	INTRA	Circular stapler	Suprapubic	Lack	Lack
Caruso et al[9]	Performed	Performed	Performed	Roux-en-Y	INTRA	Circular stapler	Upper midline	Lack	Lack
Suda et al[23]	Performed	Performed	Performed	Roux-en-Y	INTRA	Linear stapler	Not provided	Provided	Provided
Huang et al[12]	Performed	Performed		Roux-en-Y	INTRA LAP	Circular stapler	Periumbilical	Lack	Lack
Vasilescu et al[16]	Performed	Performed	Performed	Roux-en-Y	INTRA	Circular stapler	Not provided	Lack	Lack
Parisi et al[5]	Performed	Performed	Performed	Roux-en-Y	INTRA	Robot-sewn	McBurney	Provided	Provided