Short- and long-term comparison of robotic versus laparoscopic gastrectomy for gastric cancer patients with BMI>30 kg/m2: A propensity score matched analysis

Background Although minimally invasive surgery (MIS) for gastric patients has gained popularity in recent decades, reports on the comparison of short and long clinical outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for gastric cancer patients with BMI >= 30 kg/m(2) are still limited.Methods A total of 226 obese gastric cancer patients who underwent either RG (n = 81) or LG (n = 145) were enrolled in this study between October 2014 and September 2022. Propensity score matching (PSM) (1:1) was performed to reduce confounding bias. Short-term and long-term outcomes were compared between the RG and LG groups.Results The clinicopathological characteristics of 156 patients in the RG group (n = 79) and LG group (n = 79) were well balanced after PSM. Compared with the LG group, the RG group had a significantly shorter operation time, less estimated blood loss, more harvested lymph nodes, a faster postoperative recovery course, reduced surgical morbidity, and a shorter postoperative hospital stay. The long-term outcomes were comparable between the two groups.Conclusions RG is a safe and feasible approach for gastric cancer with a BMI >= 30 kg/m(2) and has better short-term clinical outcomes than LG. However, RG is similar to LG in terms of long-term prognosis.