Comparative study of the outcomes of robotic versus laparoscopic distal gastrectomy - with hand-sewn anastomosis in Billroth-I reconstruction

Sep 28, 2026

Robotic and laparoscopic distal gastrectomy with hand-sewn anastomosis for gastric cancer are compared in a retrospective, open-access research study. Total laparoscopic distal gastrectomy hand-sewn anastomosis (LDG-HA) is evaluated against robotic distal gastrectomy hand-sewn anastomosis (RDG-HA) specifically in Billroth-I reconstruction. Ninety-five patients (55 LDG-HA, 40 RDG-HA) are analyzed for baseline and pathology features, perioperative variables, short- and long-term outcomes, and 5-year oncologic results to assess efficacy and safety.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Methods

Results

Conclusion

Keywords

Zhang et al. BMC Surgery (2026) 26:1 [https://doi.org/10.1186/s12893-025-03373-y](https://doi.org/10.1186/s12893-025-03373-y) BMC Surgery RESEARCH Open Access Comparative study of the outcomes of robotic versus laparoscopic distal gastrectomy with hand-sewn anastomosis in Billroth-I reconstruction Zhenxing Zhang 1,2†, Dunbo Liu 1,3†, Shan Wang4, Bo Wang 1, Zhiwei Sun 1, Yue Meng 1, Yang Song 1, Guohang Dai 1, Dongming Liu 1, Qianshi Zhang 1,5* and Shuangyi Ren 1,5* Abstract Purpose Total laparoscopic distal gastrectomy hand-sewn anastomosis (LDG-HA) for gastric cancer (GC) is safe and effective. The objectives of our study were to investigate the efficacy and safety of laparoscopic versus robotic distal gastrectomy hand-sewn anastomosis (RDG-HA) in Billroth-I reconstruction. Methods We retrospectively analyzed the clinical data of 95 patients treated with LDG-HA (n = 55) and RDG-HA (n = 40) for GC from 09/2018 to 06/2021 . The effects on baseline, pathology, perioperative data, short-term outcomes, long-term outcomes and 5-year oncologic outcomes follow-up were analyzed. Results The difference between the clinical-pathological characteristics of the two groups was not statistically significant (P >0. 05) . The RDG-HA group was associated with a shorter anastomosis time (20 .80 min vs. 23.36 min, P = 0 . 001) but a longer operative time (176 .55 vs. 151.86 min, P = 0 . 003) and a higher cost (97661 .66 CNY vs. 71082.63 CNY, P= 0 . 000) . The differences of complications, 5-year follow-up overall survival and disease-free survival rates between the two groups were not statistically significant. Conclusion RDG-HA is safe and effective with a faster procedure of reconstruction but much more expensive. Keywords Laparoscopic gastrectomy, Robotic gastrectomy, D2 lymphadenectomy, Billroth-I, Gastric cancer †Zhenxing Zhang and Dunbo Liu these authors contributed equally to this work. *Correspondence: Qianshi Zhang [zhangqianshi1987@qq.com](zhangqianshi1987@qq.com)[ ](zhangqianshi1987@qq.com)Shuangyi Ren [renshuangyidl@163.com](renshuangyidl@163.com) 1Department of Gastrointestinal Surgery, The Second Hospital of Dalian Medical University, Dalian 116023, China 2Department of Gastrointestinal Surgery, Shaoxing People’s Hospital, Shaoxing 312000, China 3Department of Gastrointestinal Surgery, Linyi Central Hospital, Linyi 276400, China 4Department of Special Examination, Shaoxing People’s Hospital, Shaoxing 312000, China 5Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Dalian 116023, China © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/l](http://creativecommons.org/l)icenses/by/4.0/. Zhang et al. BMC Surgery (2026) 26:1 Introduction Cancer remains the number two killer worldwide after cardiovascular disease [1]. Worldwide, the mortality rate of GC has shown a clear downward trend, but in China, the overall incidence of GC ranks fourth among all tumors and the mortality rate ranks third [2]. Currently, the treatment of GC is still based on surgery asthe main comprehensive treatment. The CLASS-01 study in China, a multicenter study demons

FAQs

What is the study comparing in gastric cancer surgery?

The study compares robotic versus laparoscopic distal gastrectomy using hand-sewn anastomosis in Billroth-I reconstruction (RDG-HA vs LDG-HA).

How were patients grouped and what was the study period?

Ninety-five patients were retrospectively analyzed and divided into LDG-HA (n=55) and RDG-HA (n=40) groups, covering 09/2018 to 06/2021.

What perioperative differences were observed between RDG-HA and LDG-HA?

RDG-HA showed a shorter anastomosis time but a longer operative time and higher cost, while complication rates and survival outcomes were not significantly different.

Sep 28, 2026

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