Evidence map›Paper›PMID 41023463›Full record

SynthesisJournal of robotic surgery2025

Robotic versus laparoscopic gastrectomy for gastric cancer: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials on operative metrics, lymphadenectomy, and postoperative complications.

Wajahat Mirza, Yashal Islam Cheema, Hadi Mohammad Khan, Eshan Ahmad, Sundus Dadan, Muhammad Ahmad Nadeem

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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

6 authors.

Wajahat MirzaShifa College of Medicine, Shifa Tameer-E-Millat University, Sector H-8/4, Islamabad, Pakistan. wajahatmirza.clinicalresearch@gmail.com.ORCID http://orcid.org/0009-0001-9811-7754
Yashal Islam CheemaMedical Student, Rahbar Medical and Dental College, Lahore, Pakistan.
Hadi Mohammad KhanShifa International Hospital, Islamabad, Pakistan.
Eshan AhmadShifa College of Medicine, Shifa Tameer-E-Millat University, Sector H-8/4, Islamabad, Pakistan.
Sundus DadanShifa International Hospital, Islamabad, Pakistan.
Muhammad Ahmad NadeemDepartment of Liver Transplant, Cleveland Clinic, Cleveland, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobotic gastrectomy has emerged as a potential advancement over laparoscopic surgery for gastric cancer, offering enhanced precision through three-dimensional visualization and articulated instrumentation. However, its clinical superiority remains controversial.

methodsThis review was prospectively registered in the PROSPERO database (ID: CRD420251133133). We conducted a systematic review and meta-analysis of randomized controlled trials comparing robotic gastrectomy (RG) with laparoscopic gastrectomy (LG) for gastric adenocarcinoma. Literature searches across six databases identified eligible RCTs until January 2025. The primary outcomes included operative time, postoperative complications, blood loss, and lymph node harvest. The secondary outcomes included recovery parameters and hospital stay. Evidence certainty was assessed using the GRADE methodology.

resultsFour RCTs encompassing 919 patients (480 RG, 439 LG) met the inclusion criteria. RG significantly reduced overall postoperative complications (OR 0.49, 95% CI 0.26-0.93, P = 0.03), shortened hospital stay (MD - 0.88 days, 95% CI - 1.21 to - 0.55, P < 0.00001), and accelerated bowel function recovery (MD - 0.52 days, 95% CI - 1.00 to - 0.05, P = 0.03) and oral intake (MD - 0.52 days, 95% CI - 1.01 to - 0.03, P = 0.04). However, operative time was significantly longer (MD + 16.95 min, 95% CI 10.93-22.98, P < 0.00001). Severe complications, anastomotic leakage, reoperation rates, blood loss, and lymph node yield were comparable between the approaches. GRADE assessment revealed moderate certainty for hospital stay reduction and low-to-very-low certainty for other outcomes due to heterogeneity and methodological limitations of the studies.

conclusionsAcross four RCTs conducted in high-volume East Asian centers, robotic gastrectomy demonstrates superior perioperative recovery with reduced overall complications and accelerated rehabilitation compared with laparoscopic surgery, despite longer operative times. Oncological adequacy remains equivalent across approaches. Generalizability to Western case-mix and perioperative pathways remains uncertain.

Indexed as

GastrectomyLaparoscopyLymph Node ExcisionPostoperative ComplicationsRobotic Surgical ProceduresStomach NeoplasmsBlood Loss, SurgicalHumansLength of StayOperative TimeRandomized Controlled Trials as TopicGastric cancerLaparoscopic gastrectomyMeta-analysisPerioperative outcomesRandomized controlled trialsRobotic gastrectomy

Identifiers

PMID41023463

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.