The value of robot-assisted gastrectomy in the treatment of gastric cancer: a systematic review and meta-analysis.

BACKGROUND

Open gastrectomy (OG) has long been the standard for gastric cancer surgery. Robotic gastrectomy (RG) has emerged as a minimally invasive alternative with potential technical advantages, but large-sample meta-analyses comparing their clinical value are limited. This study aims to evaluate its clinical practical application value and provide a reference for clinical practice.

METHODS

A systematic search was conducted in PubMed, EMBASE, MEDLINE, Web of Science, and Cochrane Library up to July 2025, following PRISMA guidelines, with statistical analysis using STATA 12.

RESULTS

Seventeen studies involving 31,573 patients (10,524 RG, 21,049 OG) were included. RG had longer operative time (WMD: 93.4; 95% CI: 65.89-120.9; P < 0.001) but less blood loss (WMD: -86.71; 95% CI: -120.91--52.52; P < 0.001), shorter hospital stay (WMD: -3.17 days; 95% CI: -4.17--2.16; P < 0.001), lower postoperative complication rate (OR: 0.61; 95% CI: 0.43-0.87; P = 0.006), and higher R0 resection rate (OR: 1.88; 95% CI: 1.57-2.24; P = 0.000). No significant differences were found in lymph nodes, positive lymph nodes, postoperative mortality, or 5-year survival.

CONCLUSION

RG is a reasonable choice for proficient robotic surgery centers, balancing invasiveness and oncological precision. Future studies should focus on long-term outcome and quality of life to guide clinical decision-making.