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<p>The introduction of robotic surgical platforms has addressed several inherent technical constraints associated with conventional laparoscopy. Nevertheless, it remains uncertain whether robotic gastrectomy (RG), in comparison with laparoscopic gastrectomy (LG), provides superior perioperative outcomes and long-term survival benefits in patients affected by gastric cancer (GC). We searched the published literature from three principal databases, PubMed, EMBASE, and Web of Science. Data, such as research features, individual traits and consequent parameters, were extracted. ROB 2 and ROBINS-I V2 was used to evaluate study quality, as appropriate. The primary survival outcomes indicators were overall survival (OS), relapse-free survival (RFS) and disease-free survival (DFS). Our search yielded 4691 studies. Eighty-four studies, which contained 39,635 patients, were included. RG was associated with improved OS [hazard ratio (HR) 0.89, 95% CI 0.83–0.95] and RFS [hazard ratio (HR) 0.79, 95% CI 0.65–0.96], fewer postoperative complications [odds ratio (OR) 0.77, 95% CI 0.70–0.86], The complication benefit was mainly driven by a reduction in moderate-to-severe complications (Clavien-Dindo ≥ III OR 0.71), longer surgeries [weighted mean difference (WMD) 28.23, 95% CI 22.87–33.58], lower estimated blood loss [weighted mean difference (WMD) − 21.97, 95% CI − 26.34 to − 18.59], greater numbers of retrieved lymph nodes [weighted mean difference (WMD) 1.70, 95% CI 0.87–2.54], and shorter postoperative hospital stays [weighted mean difference (WMD) − 0.60, 95% CI -0.80 to -0.41]. RG was associated with higher costs than LG [weighted mean difference (WMD) 1.26, 95% CI 0.93–1.58]. DFS showed no significant difference. Subgroup Analysis: The Japanese subgroup outperformed the Chinese and Korean subgroups in long-term survival. Our research indicates that RG has modest perioperative advantages for gastric cancer treatment and shows potential long-term survival benefits.</p>

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Robotic versus laparoscopic gastrectomy for gastric cancer: a systematic review and meta-analysis of perioperative outcome and long-term survival

  • 期刊论文

  • 发表日期：

    2026年4月21日

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  • Zhe-Yu Shen,
  • Zi-Qi Wang,
  • Tian-Chi Yu,
  • Qi Wang,
  • Fan Yang,
  • Ren-Fei Zhu

摘要

The introduction of robotic surgical platforms has addressed several inherent technical constraints associated with conventional laparoscopy. Nevertheless, it remains uncertain whether robotic gastrectomy (RG), in comparison with laparoscopic gastrectomy (LG), provides superior perioperative outcomes and long-term survival benefits in patients affected by gastric cancer (GC). We searched the published literature from three principal databases, PubMed, EMBASE, and Web of Science. Data, such as research features, individual traits and consequent parameters, were extracted. ROB 2 and ROBINS-I V2 was used to evaluate study quality, as appropriate. The primary survival outcomes indicators were overall survival (OS), relapse-free survival (RFS) and disease-free survival (DFS). Our search yielded 4691 studies. Eighty-four studies, which contained 39,635 patients, were included. RG was associated with improved OS [hazard ratio (HR) 0.89, 95% CI 0.83–0.95] and RFS [hazard ratio (HR) 0.79, 95% CI 0.65–0.96], fewer postoperative complications [odds ratio (OR) 0.77, 95% CI 0.70–0.86], The complication benefit was mainly driven by a reduction in moderate-to-severe complications (Clavien-Dindo ≥ III OR 0.71), longer surgeries [weighted mean difference (WMD) 28.23, 95% CI 22.87–33.58], lower estimated blood loss [weighted mean difference (WMD) − 21.97, 95% CI − 26.34 to − 18.59], greater numbers of retrieved lymph nodes [weighted mean difference (WMD) 1.70, 95% CI 0.87–2.54], and shorter postoperative hospital stays [weighted mean difference (WMD) − 0.60, 95% CI -0.80 to -0.41]. RG was associated with higher costs than LG [weighted mean difference (WMD) 1.26, 95% CI 0.93–1.58]. DFS showed no significant difference. Subgroup Analysis: The Japanese subgroup outperformed the Chinese and Korean subgroups in long-term survival. Our research indicates that RG has modest perioperative advantages for gastric cancer treatment and shows potential long-term survival benefits.