Short‐term outcomes of laparoscopic and robotic distal gastrectomy for gastric cancer: Real‐world evidence from a large‐scale inpatient database in Japan

Abstract Background and Objectives Robotic distal gastrectomy (RDG) has been widely performed throughout Japan since it became insured in 2018. This study aimed to evaluate the short‐term outcomes of RDG and laparoscopic distal gastrectomy (LDG) for gastric cancer using real‐world data. Methods A total of 4161 patients who underwent LDG ( n = 3173) or RDG ( n = 988) for gastric cancer between April 2018 and October 2022 were identified through the Japanese Diagnosis Procedure Combination Database, which covers 42 national university hospitals. The primary outcome was postoperative in‐hospital mortality rate. The secondary outcomes were postoperative complication rates, time to diet resumption, and postoperative length of stay (LOS). Results In‐hospital mortality and postoperative complication rates in the RDG group were comparable with those in the LDG group (0.1% vs. 0.0%, p = 1.000, and 8.7% vs. 8.2%, p = 0.693, respectively). RDG was associated with a longer duration of anesthesia (325 vs. 262 min, p < 0.001), similar time to diet resumption (3 vs. 3 days, p < 0.001), and shorter postoperative LOS (10 vs. 11 days, p < 0.001) compared with LDG. Conclusions RDG was performed safely and provided shorter postoperative LOS, since it became covered by insurance in Japan.