Evidence map›Paper›PMID 41803552›Full record

ArticleJournal of robotic surgery2026

Safety, technical transferability, and oncological outcomes of multi-institutional robotic distal gastrectomy for gastric cancer: impact of surgeons qualified under the endoscopic surgical skill qualification system of the Japan Society for Endoscopic Surgery.

Yuma Ebihara, Noriaki Kyogoku, Hironobu Takano, Hideyuki Wada, Takeo Nitta, Daisuke Saikawa, Yoshiyuki Yamamura, Minoru Takada, Toshiaki Shichinohe, Satoshi Hirano

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Yuma EbiharaDepartment of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, 060-8638, Japan. yuma-ebi@wc4.so-net.ne.jp.ORCID http://orcid.org/0000-0002-7317-8067
Noriaki KyogokuDepartment of Surgery, Japanese Redcross Kitami Hospital, Kitami, Japan.
Hironobu TakanoDepartment of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
Hideyuki WadaDepartment of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
Takeo NittaDepartment of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
Daisuke SaikawaDepartment of Surgery, Tonan Hospital, Sapporo, Japan.
Yoshiyuki YamamuraDepartment of Surgery, Obihiro-Kosei General Hospital, Obihiro, Japan.
Minoru TakadaDepartment of Surgery, Teine Keijinkai Hospital, Sapporo, Japan.
Toshiaki ShichinoheDepartment of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
Satoshi HiranoDepartment of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To evaluate the learning curve, clinical safety, and 3-year oncological outcomes of robotic distal gastrectomy (RDG) for gastric cancer (GC) during its multi-institutional introduction. We focused on the impact of surgeons who qualified under the Endoscopic Surgical Skill Qualification System (ESSQS) of the Japan Society for Endoscopic Surgery (JSES). We analyzed 251 consecutive patients who underwent RDG for GC at five affiliated institutions. The patients were divided into phases 1 (cases 1–59) and 2 (cases 60–251) based on a cumulative sum (CUSUM)-defined learning curve for operative time. Although the CUSUM analysis identified a statistical transition point at the 59th case, clinical outcomes, including complication rates (phase 1 vs. phase 2; Clavien–Dindo ≥ III: 8.5% vs. 3.1%, P = 0.102), were consistently stable from outset. Although phase 2 included advanced clinical stages (cStage II/III: 15.3% vs. 30.2%, P = 0.035) and older patients (median age: 67 vs. 72 years, P < 0.001), operative times remained stable (median: 340 vs. 331.5 min, P = 0.430), and the number of harvested lymph nodes significantly increased (median 33 vs. 37, P = 0.040). Three-year overall (93.1% vs. 93.0%, P = 0.878) and relapse-free (89.6% vs. 91.8%, P = 0.995) survival rates were comparable between the phases. Sub-analysis revealed that JSES ESSQS-qualified colorectal specialists achieved safety profiles comparable with those of gastric specialists, despite longer operative times. RDG can be safely performed without early-phase risk when led by JSES ESSQS-qualified surgeons. Their high baseline proficiency ensures stable clinical safety and favorable oncological outcomes, even as indications expand to complex cases.

Indexed as

Clinical CompetenceGastrectomyRobotic Surgical ProceduresStomach NeoplasmsSurgeonsAgedFemaleHumansJapanLearning CurveMaleMiddle AgedOperative TimePostoperative ComplicationsSocieties, MedicalTreatment OutcomeEndoscopic Surgical Skill Qualification SystemLearning curveRobotic distal gastrectomyTechnical transferability

Identifiers

PMID41803552

What OpenQuestion holds

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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.