Comparative analysis of the efficacy and safety of complete da Vinci robot versus laparoscopy in total gastrectomy and delayed detached gastric modified Overlap esophagojejunostomy for gastric cancer: a retrospective cohort study

Abstract Objective：To investigate the feasibility and safety of fluorescence laparoscopic intraoperative positioning combined with complete da Vinci robotic total gastrectomy for gastric cancer and delayed detachment of the stomach in modified Overlap oesophagojejunostomy. Methods：The clinical data of 22 gastric cancer patients treated with fluorescent laparoscopic intraoperative localization combined with complete da Vinci robotic total gastrectomy or fluorescent laparoscopic total gastrectomy at the Department of Oncology, the Second Hospital of Lanzhou University, were retrospectively analyzed and relevant literature was searched and reviewed. Results：The clinical data of 22 patients were included for analysis, including 11 in the laparoscopic group and 11 in the robotic group. All surgeries were successfully completed. In terms of baseline data, there was no statistically significant difference between the two groups. Robotic group was higher than laparoscopic group in terms of operative time and hospitalisation costs (P<0.05); the neutrophil ratio on the third postoperative day was lower in the robotic group than in the laparoscopic group (P <0.05); the comparison between the first five cases and the last six cases in the robotic group showed that the intraoperative blood loss in the last six cases was lower than that in the first five cases (P<0.05). Conclusions：Intraoperative localization with fluorescence laparoscopy combined with total robotic gastrectomy for gastric cancer and modified Overlap esophagojejunostomy with delayed gastric transection has equivalent efficacy to fluorescence laparoscopy total gastrectomy, and is safe and feasible. With the increase of surgical proficiency, intraoperative blood loss can be better controlled, which is worthy of clinical promotion and application.