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<p>To compare the perioperative outcomes of a novel laparoscopic-like 3-arm + 2-port and traditional 4-arm + 1-port models in robot-assisted distal gastrectomy with Billroth II reconstruction in patients with resectable, non-metastatic gastric cancer. This randomized controlled trial included patients with resectable, non-metastatic gastric cancer who underwent robot-assisted distal gastrectomy with Billroth II reconstruction with Braun anastomosis and D2 lymphadenectomy. Patients were randomly allocated into two groups based on trocar port placement: traditional 4 + 1 and novel laparoscopic-like 3 + 2 models, using a computer-generated stratified blocked randomization sequence. Outcome measures included operative times, intraoperative blood loss, lymph node yield, postoperative outcomes, and operating room costs. A total of 195 patients were included: 98 in the 3 + 2 group and 97 in the 4 + 1 group. The total operative time was significantly shorter in the 3 + 2 group than in the 4 + 1 group (207.14 ± 22.214 vs. 221.38 ± 26.689&#xa0;min, <i>p</i> &lt; 0.001). Subsequently, significant reductions in the regional and non-operative times, including omentectomy, stations 4sb, 6, 5/12, 11p/8a/7/9, and 1/3 lymph node dissection, robotic arm docking and switching, and target organ exposure times were also demonstrated in the 3 + 2 group. Significantly more lymph nodes were harvested from station 4sb in the 3 + 2 group (5.26 ± 1.431 vs. 4.70 ± 1.393, <i>p</i> = 0.007). Operating room costs were also significantly lower in the 3 + 2 group (CNY 15,140.56 ± 2,712.21 vs. CNY 18,650.03 ± 1,497.41, <i>p</i> &lt; 0.001). This novel 3 + 2 laparoscopic-like model represents a technically viable and economically advantageous alternative to robot-assisted distal gastrectomy for patients with gastric cancer.</p>

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Perioperative outcomes of a novel laparoscopic-like “3-arm + 2-port” model in robot-assisted distal gastrectomy in patients with resectable, non-metastatic gastric cancer: a randomized controlled trial

  • 期刊论文

  • 发表日期：

    2026年7月22日

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  • Yeqian Zhang,
  • Linnelle Stacy T. Lao,
  • Xiaoyao Shen,
  • Xiang Xia,
  • Puhua Zhang,
  • Zihang Liu,
  • Junjie Wang,
  • Bo Ni,
  • Zizhen Zhang

摘要

To compare the perioperative outcomes of a novel laparoscopic-like 3-arm + 2-port and traditional 4-arm + 1-port models in robot-assisted distal gastrectomy with Billroth II reconstruction in patients with resectable, non-metastatic gastric cancer. This randomized controlled trial included patients with resectable, non-metastatic gastric cancer who underwent robot-assisted distal gastrectomy with Billroth II reconstruction with Braun anastomosis and D2 lymphadenectomy. Patients were randomly allocated into two groups based on trocar port placement: traditional 4 + 1 and novel laparoscopic-like 3 + 2 models, using a computer-generated stratified blocked randomization sequence. Outcome measures included operative times, intraoperative blood loss, lymph node yield, postoperative outcomes, and operating room costs. A total of 195 patients were included: 98 in the 3 + 2 group and 97 in the 4 + 1 group. The total operative time was significantly shorter in the 3 + 2 group than in the 4 + 1 group (207.14 ± 22.214 vs. 221.38 ± 26.689 min, p < 0.001). Subsequently, significant reductions in the regional and non-operative times, including omentectomy, stations 4sb, 6, 5/12, 11p/8a/7/9, and 1/3 lymph node dissection, robotic arm docking and switching, and target organ exposure times were also demonstrated in the 3 + 2 group. Significantly more lymph nodes were harvested from station 4sb in the 3 + 2 group (5.26 ± 1.431 vs. 4.70 ± 1.393, p = 0.007). Operating room costs were also significantly lower in the 3 + 2 group (CNY 15,140.56 ± 2,712.21 vs. CNY 18,650.03 ± 1,497.41, p < 0.001). This novel 3 + 2 laparoscopic-like model represents a technically viable and economically advantageous alternative to robot-assisted distal gastrectomy for patients with gastric cancer.