Comparison Of Trobotic Versus Laparoscopic Gastrectomy Combined With Enhanced Recovery After Suigery For Gastric Cancer:A Propensity Score Matching Analysis

Objective To compare the surgical outcome of robotic and laparoscopic gastrectomy combined with enhanced recovery after surgery(ERAS)for the gastric cancer by using propensity score matching(PSM).Methods A retrospective review of a prospectively collected database identified 223 consecutive patients who underwent either RAG(n=71)or LAG(n=152)combined with enhanced recovery after surgery(ERAS)for gastric cancer between January 2016 and October 2018 at the first affiliated hospital of guangxi medical university.A 1:1 matched propensity score analysis was performed.The surgical outcomes and hospital costs between the two groups were compared.Results A well-balanced cohort of 86 patients was analyzed(RAG:LAG=1:1match).The operation times were(6.01 ± 1.15)h for the RAG group and(4.45 ± 1.13)h for the LAG group(P<0.001).RAG group was associated with a lower blood loss(148.14 ± 117.94)ml in RAG group and(201.86 ± 120.93)ml in LAG group,(P<0.05).Shorter time of first venting(38.79 ± 10.65)h in RAG group and(43.65 ± 9.44)h in LAG group,(P < 0.05).Shorter days of postoperative hospital stay(6.26 ± 2.14)d in RAG group and(7.44 ± 2.21)d in LAG group,(P< 0.05).RAG group was much more costly than LAG group(83901.07 ±10741.66)yuan in RAG group and(65958.72 ± 10193.50)yuan in LAG group,(P <0.001).The major complication rates,total numbers of retrieved lymph nodes,VAS,first time of oral intake for RAG group and LAG group were similar.Conclusion Propensity score matching can effectively reduce the influence of confounding factors on the results of retrospective study.RAG is a feasible and safe surgical procedure combined with enhanced recovery after surgery for gastric cancer.