Clinical benefits including the postoperative inflammatory status of robot-assisted distal gastrectomy for gastric cancer compared with laparoscopic distal gastrectomy in patients with obesity

Abstract

Abstract This study aimed to clarify the clinical benefits of robot-assisted distal gastrectomy (RDG) versus laparoscopic distal gastrectomy (LDG) in patients with obesity. The analysis included 89 and 87 patients in LDG and RDG groups, respectively. The associations between body mass index (BMI) and surgical outcomes including postoperative inflammation were compared between LDG and RDG. Incidences of postoperative complications did not show a significant difference between LDG and RDG. The operating time and blood loss increased with BMI in the LDG group, whereas no such correlation was observed in the RDG group. While BMI and C-reactive protein (CRP) levels on postoperative day (POD) 3 showed a significant correlation in LDG (R = 0.393, p < 0.001), RDG did not show a correlation. In patients with BMI ≥ 25 (kg/m 2 ), CRP on POD 3 was significantly lower in RDG than in LDG. Multivariate analysis for CRP on POD 3 in patients with BMI ≥ 25 identified RDG and operating time ≥ 360 min as independent associated factors ( B = − 6.887; p = 0.003 and B = 6.068; p = 0.011). RDG was indicated to reduce blood loss and suppress the postoperative CRP elevation compared with LDG, particularly in patients with high BMI.