{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T14:51:36Z","timestamp":1781621496398,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T00:00:00Z","timestamp":1767398400000},"content-version":"vor","delay-in-days":39,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Wu Jieping Medical Foundation Clinical Research Special Funding","award":["No. 320.6750"],"award-info":[{"award-number":["No. 320.6750"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed the clinical data of 95 patients treated with LDG-HA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955) and RDG-HA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940) 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The difference between the clinical-pathological characteristics of the two groups was not statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.05). The RDG-HA group was associated with a shorter anastomosis time (20.80\u00a0min vs. 23.36\u00a0min,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) but a longer operative time (176.55 vs. 151.86\u00a0min,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003) and a higher cost (97661.66 CNY vs. 71082.63 CNY,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.000). The differences of complications, 5-year follow-up overall survival and disease-free survival rates between the two groups were not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RDG-HA is safe and effective with a faster procedure of reconstruction but much more expensive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-025-03373-y","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T09:35:10Z","timestamp":1764063310000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative study of the outcomes of robotic versus laparoscopic distal gastrectomy with hand-sewn anastomosis in Billroth-I reconstruction"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-172X","authenticated-orcid":false,"given":"Zhenxing","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dunbo","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohang","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongming","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianshi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuangyi","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"issue":"1","key":"3373_CR1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","volume":"74","author":"RL Siegel","year":"2024","unstructured":"Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12\u201349. https:\/\/doi.org\/10.3322\/caac.21820.","journal-title":"CA Cancer J Clin"},{"issue":"3","key":"3373_CR2","doi-asserted-by":"publisher","first-page":"221","DOI":"10.3760\/cma.j.cn112152-20240119-00035","volume":"46","author":"RS Zheng","year":"2024","unstructured":"Zheng RS, Chen R, Han BF, et al. Cancer incidence and mortality in China, 2022. Zhonghua Zhong Liu Za Zhi. 2024;46(3):221\u201331.\u00a0Chinese.\u00a0https:\/\/doi.org\/10.3760\/cma.j.cn112152-20240119-00035. PMID: 38468501.","journal-title":"Zhonghua Zhong Liu Za Zhi."},{"issue":"1","key":"3373_CR3","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1001\/jamasurg.2021.5104","volume":"157","author":"C Huang","year":"2022","unstructured":"Huang C, Liu H, Hu Y, Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) Group, et al. Laparoscopic vs Open Distal Gastrectomy for Locally Advanced Gastric Cancer: Five-Year Outcomes From the CLASS-01 Randomized Clinical Trial. JAMA Surg. 2022;157(1):9\u201317. https:\/\/doi.org\/10.1001\/jamasurg.2021.5104.","journal-title":"JAMA Surg"},{"issue":"2","key":"3373_CR4","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/s1072-7515(02)01239-5","volume":"195","author":"S Kanaya","year":"2002","unstructured":"Kanaya S, Gomi T, Momoi H, et al. Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy. J Am Coll Surg. 2002;195(2):284\u20137. https:\/\/doi.org\/10.1016\/s1072-7515(02)01239-5.","journal-title":"J Am Coll Surg"},{"issue":"11","key":"3373_CR5","doi-asserted-by":"publisher","first-page":"2997","DOI":"10.1007\/s12325-019-01104-3","volume":"36","author":"Z Ren","year":"2019","unstructured":"Ren Z, Wang WX. Comparison of Billroth I, Billroth II, and Roux-en-Y Reconstruction After Totally Laparoscopic Distal Gastrectomy: A Randomized Controlled Study. Adv Ther. 2019;36(11):2997\u20133006. https:\/\/doi.org\/10.1007\/s12325-019-01104-3.","journal-title":"Adv Ther"},{"issue":"5","key":"3373_CR6","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1007\/s005950300084","volume":"33","author":"S Takiguchi","year":"2003","unstructured":"Takiguchi S, Sekimoto M, Miyake Y, et al. Totally laparoscopic distal gastrectomy using the hand-sewn Billroth-I anastomotic technique: report of a case. Surg Today. 2003;33(5):371\u20134. https:\/\/doi.org\/10.1007\/s005950300084.","journal-title":"Surg Today"},{"issue":"6","key":"3373_CR7","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1016\/S0039-6109(03)00158-0","volume":"83","author":"M Hashizume","year":"2003","unstructured":"Hashizume M, Sugimachi K. Robot-assisted gastric surgery. Surg Clin North Am. 2003;83(6):1429\u201344. https:\/\/doi.org\/10.1016\/S0039-6109(03)00158-0.","journal-title":"Surg Clin North Am"},{"issue":"6","key":"3373_CR8","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1097\/01.sla.0000351688.64999.73","volume":"249","author":"J Song","year":"2009","unstructured":"Song J, Oh SJ, Kang WH, et al. Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg. 2009;249(6):927\u201332. https:\/\/doi.org\/10.1097\/01.sla.0000351688.64999.73.","journal-title":"Ann Surg"},{"issue":"1","key":"3373_CR9","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1186\/s12893-021-01207-1","volume":"21","author":"X Zhang","year":"2021","unstructured":"Zhang X, Zhang W, Yuan M, et al. Application of double layered end-to-end anastomosis with continuous manual suture for completing digestive tract reconstruction in totally laparoscopic distal gastrectomy. BMC Surg. 2021;21(1):213. https:\/\/doi.org\/10.1186\/s12893-021-01207-1. PMID: 33902547; PMCID: PMC8077891.","journal-title":"BMC Surg"},{"key":"3373_CR10","volume-title":"Japanese classification of gastric carcinoma","author":"Japanese Gastric Cancer Association","year":"2017","unstructured":"Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma. 15th ed. Tokyo, Japan: Kanehara; 2017.","edition":"15"},{"key":"3373_CR11","volume-title":"AJCC cancer staging manual","author":"MB Amin","year":"2016","unstructured":"Amin MB, Edge S, Greene F, et al. AJCC cancer staging manual. 8th ed. New York, NY: Springer; 2016.","edition":"8"},{"issue":"2","key":"3373_CR12","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","volume":"240","author":"D Dindo","year":"2004","unstructured":"Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205\u201313. https:\/\/doi.org\/10.1097\/01.sla.0000133083.54934.ae.","journal-title":"Ann Surg"},{"issue":"2","key":"3373_CR13","first-page":"146","volume":"4","author":"S Kitano","year":"1994","unstructured":"Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4(2):146\u20138.","journal-title":"Surg Laparosc Endosc"},{"key":"3373_CR14","doi-asserted-by":"publisher","first-page":"1673","DOI":"10.1007\/s13304-021-01059-7","volume":"73","author":"L Marano","year":"2021","unstructured":"Marano L, Fusario D, Savelli V, Marrelli D, Roviello F. Robotic versus laparoscopic gastrectomy for gastric cancer: an umbrella review of systematic reviews and meta-analyses. Updates Surg. 2021;73:1673\u201389.","journal-title":"Updates Surg"},{"issue":"6","key":"3373_CR15","doi-asserted-by":"publisher","first-page":"1851","DOI":"10.1007\/s13304-022-01396-1","volume":"74","author":"V Aliyev","year":"2022","unstructured":"Aliyev V, Piozzi GN, Bulut A, Guven K, Bakir B, Saglam S, et al. Robotic vs. laparoscopic intersphincteric resection for low rectal cancer: a case matched study reporting a median of 7-year long-term oncological and functional outcomes. Update Surg. 2022;74(6):1851\u201360. https:\/\/doi.org\/10.1007\/s13304-022-01396-1. (Epub 2022 Oct 5. PMID: 36198884).","journal-title":"Update Surg"},{"key":"3373_CR16","first-page":"93","volume":"37","author":"V Aliyev","year":"2020","unstructured":"Aliyev V, Tokmak H, Goksel S, Guven K, Bakir B, Kay H, Asoglu O. Robotic Sphincter-Saving total mesorectal excision for rectal cancer treatment: A Single-Surgeon experience in 103 consecutive male patients. Surg Technol Int. 2020;37:93\u20138. PMID: 32634247.","journal-title":"Surg Technol Int"},{"key":"3373_CR17","doi-asserted-by":"publisher","first-page":"160","DOI":"10.52198\/21.STI.38.CR1391","volume":"38","author":"V Aliyev","year":"2021","unstructured":"Aliyev V, Goksel S, Bakir B, Guven K, Asoglu O. Sphincter-saving robotic total mesorectal excision provides better mesorectal specimen and good oncological local control compared with laparoscopic total mesorectal excision in male patients with mid-low rectal cancer. Surg Technol Int. 2021;38:160\u20136. https:\/\/doi.org\/10.52198\/21.STI.38.CR1391.","journal-title":"Surg Technol Int"},{"issue":"10","key":"3373_CR18","doi-asserted-by":"publisher","first-page":"7530","DOI":"10.1007\/s00464-023-10204-9","volume":"37","author":"C Takahashi","year":"2023","unstructured":"Takahashi C, Glasser J, Schuster C, Huston J, Shridhar R, Meredith K. Comparative outcomes of laparoscopic and robotic approaches to gastrectomy: a National Cancer Database study. Surg Endosc. 2023;37(10):7530\u20137. https:\/\/doi.org\/10.1007\/s00464-023-10204-9.","journal-title":"Surg Endosc"},{"key":"3373_CR19","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1016\/j.ijrobp.2005.05.005","volume":"63","author":"S Kim","year":"2005","unstructured":"Kim S, Lim DH, Lee J, Kang WK, MacDonald JS, Park CH, et al. An observational study suggesting clinical benefit for adjuvant postoperative chemoradiation in a population of over 500 cases after gastric resection with D2 nodal dissection for adenocarcinoma of the stomach. Int J Radiat Oncol Biol Phys. 2005;63:1279\u201385.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"3373_CR20","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/S0140-6736(11)61873-4","volume":"379","author":"YJ Bang","year":"2012","unstructured":"Bang YJ, Kim YW, Yang HK, Chung HC, Park YK, Lee KH, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet. 2012;379:315\u201332.","journal-title":"Lancet"},{"key":"3373_CR21","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1097\/SLA.0000000000004466","volume":"273","author":"J Lu","year":"2021","unstructured":"Lu J, Zheng CH, Xu BB, Xie JW, Wang JB, Lin JX, et al. Assessment of robotic versus laparoscopic distal gastrectomy for gastric cancer: a randomized controlled trial. Ann Surg. 2021;273:858\u201367.","journal-title":"Ann Surg"},{"key":"3373_CR22","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1007\/s00268-020-05939-8","volume":"45","author":"M Hikage","year":"2021","unstructured":"Hikage M, Fujiya K, Kamiya S, Tanizawa Y, Bando E, Notsu A, et al. Robotic gastrectomy compared with laparoscopic gastrectomy for clinical stage I\/II gastric cancer patients: a propensity score-matched analysis. World J Surg. 2021;45:1483\u201394.","journal-title":"World J Surg"},{"issue":"6","key":"3373_CR23","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.cireng.2020.09.018","volume":"99","author":"H Jiang","year":"2021","unstructured":"Jiang H, Li Y, Wang T. Comparison of Billroth I, Billroth II, and Roux-en-Y reconstructions following distal gastrectomy: a systematic review and network meta-analysis. Cir Esp (Engl Ed). 2021;99(6):412\u201320. https:\/\/doi.org\/10.1016\/j.cireng.2020.09.018.","journal-title":"Cir Esp (Engl Ed)"},{"issue":"1","key":"3373_CR24","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-021-02249-8","volume":"19","author":"Z Wang","year":"2021","unstructured":"Wang Z, Wei Y, Liu X, Li Z, Zhu G, Li Y, et al. Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer. World J Surg Oncol. 2021;19(1):229. https:\/\/doi.org\/10.1186\/s12957-021-02249-8.","journal-title":"World J Surg Oncol"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-025-03373-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-025-03373-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-025-03373-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T13:53:47Z","timestamp":1781618027000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12893-025-03373-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3373"],"URL":"https:\/\/doi.org\/10.1186\/s12893-025-03373-y","relation":{},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,25]]},"assertion":[{"value":"6 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All patients provided informed consent, which were registered in the medical record. This paper confirms to the principles and requirements of Academic Ethics Committee of the Second Hospital of Dalian Medical University.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1"}}