Evidence map›Paper›PMID 37943334›Full record

ArticleSurgical endoscopy2023

Robotic versus laparoscopic gastrectomy for adenocarcinoma in the US: a propensity score-matching analysis of 11,173 patients on oncological adequacy.

Felipe B Maegawa, Ankit D Patel, Snehal G Patel, Jamil L Stetler, Dipan C Patel, Yazan Ashouri, Juan M Sarmiento, Ioannis T Konstantinidis, Edward Lin

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. [Robotic gastrectomy: Research progress and practical challenges].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026
    Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Felipe B MaegawaDivision of General & Gastrointestinal Surgery, Department of Surgery, Emory University, 5673 Peachtree Dunwoody Rd, Suite 680, Atlanta, GA, 30342, USA. fmaegaw@emory.edu.ORCID 0000-0002-3289-6054
Ankit D PatelDivision of General & Gastrointestinal Surgery, Department of Surgery, Emory University, 5673 Peachtree Dunwoody Rd, Suite 680, Atlanta, GA, 30342, USA.
Snehal G PatelDivision of General & Gastrointestinal Surgery, Department of Surgery, Emory University, 5673 Peachtree Dunwoody Rd, Suite 680, Atlanta, GA, 30342, USA.
Jamil L StetlerDivision of General & Gastrointestinal Surgery, Department of Surgery, Emory University, 5673 Peachtree Dunwoody Rd, Suite 680, Atlanta, GA, 30342, USA.
Dipan C PatelDivision of General & Gastrointestinal Surgery, Department of Surgery, Emory University, 5673 Peachtree Dunwoody Rd, Suite 680, Atlanta, GA, 30342, USA.
Yazan AshouriSaint Vincent Medical Center, Mercy Health, Toledo, OH, USA.
Juan M SarmientoDivision of General & Gastrointestinal Surgery, Department of Surgery, Emory University, 5673 Peachtree Dunwoody Rd, Suite 680, Atlanta, GA, 30342, USA.
Ioannis T KonstantinidisDivision of Surgical Oncology, Department of Surgery, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Edward LinDivision of General & Gastrointestinal Surgery, Department of Surgery, Emory University, 5673 Peachtree Dunwoody Rd, Suite 680, Atlanta, GA, 30342, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSurgery remains the cornerstone treatment for gastric cancer. Previous studies have reported better lymphadenectomy with minimally invasive approaches. There is a paucity of data comparing robotic and laparoscopic gastrectomy in the US. Herein, we examined whether oncological adequacy differs between laparoscopic and robotic approaches.

methodsThe National Cancer Database was utilized to identify patients who underwent gastrectomy for adenocarcinoma between 2010 and 2019. A propensity score-matching analysis between robotic gastrectomy (RG) versus laparoscopic gastrectomy (LG) was performed. The primary outcomes were lymphadenectomy ≥ 16 nodes and surgical margins.

resultsA total of 11,173 patients underwent minimally invasive surgery for gastric adenocarcinoma between 2010 and 2019. Of those 8320 underwent LG and 2853 RG. Comparing the unmatched cohorts, RG was associated with a higher rate of adequate lymphadenectomy (63.5% vs 57.1%, p < .0.0001), higher rate of negative margins (93.8% vs 91.9%, p < 0.001), lower rate of prolonged length of stay (26.0% vs 29.6%, p < .0.001), lower 90-day mortality (3.7% vs 5.0%, p < 0.0001), and a better 5-year overall survival (OS) (56% vs 54%, p = 0.03). A propensity score-matching cohort with a 1:1 ratio was created utilizing the variables associated with lymphadenectomy ≥ 16 nodes. The matched analysis revealed that the rate of adequate lymphadenectomy was significantly higher for RG compared to LG, 63.5% vs 60.4% (p = 0.01), respectively. There was no longer a significant difference between RG and LG regarding the rate of negative margins, prolonged length of stay, 90-day mortality, rate of receipt of postoperative chemotherapy, and OS.

conclusionsThis propensity score-matching analysis with a large US cohort shows that RG was associated with a higher rate of adequate lymphadenectomy compared to LR. RG and LG had a similar rate of negative margins, prolonged length of stay, receipt of postoperative chemotherapy, 90-day mortality, and OS, suggesting that RG is a comparable surgical approach, if not superior to LG.

Indexed as

AdenocarcinomaLaparoscopyRobotic Surgical ProceduresStomach NeoplasmsGastrectomyHumansPostoperative ComplicationsPropensity ScoreRetrospective StudiesTreatment OutcomeGastrectomyGastric cancerLaparoscopicRobotic

Identifiers

PMID37943334

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.