The benefit of robotic gastrectomy in minimally invasive surgery for elderly patients: a propensity score-matched analysis.

PURPOSES: Robotic gastrectomy (RG) offers superior dexterity and visualization compared with laparoscopic gastrectomy (LG). However, its high cost requires careful patient selection. This study aimed to evaluate whether these advantages provide clinical benefits for elderly patients who are vulnerable to surgical stress.

METHODS

This retrospective study included 656 patients with gastric or esophagogastric junction cancer who underwent R0 RG or LG. The patients were stratified into elderly (≥ 75 years, n = 300) and non-elderly (< 75 years, n = 356). Propensity score matching was performed within each group to adjust baseline differences, and the outcomes were compared.

RESULTS

In elderly patients, RG caused fewer postoperative complications (grade ≥ III) (3.0% vs. 11.0%, P = 0.03) and lower postoperative C-reactive protein (P = 0.03) and drain amylase levels (P = 0.02). In non-elderly patients, RG led to lower drain amylase levels (P = 0.002). However, the complication rates did not differ significantly (3.8% vs. 7.6%, P = 0.29). No significant differences in the recurrence-free survival or overall survival were observed.

CONCLUSIONS

RG may reduce postoperative complications in elderly patients, thus supporting a potential benefit in this population.