Identifying the best candidates for reduced port gastrectomy

Area of Science:

• Gastroenterology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Previous research focused on the non-inferiority of robotic port gastrectomy (RPG) versus conventional port gastrectomy (CPG).
• This study investigates potential superior benefits of RPG for specific patient subgroups.

Purpose of the Study:

• To compare surgical trauma, bowel recovery, and hospital stay between RPG and CPG.
• To identify patient groups who benefit most from RPG.

Main Methods:

• Retrospective analysis of 1442 gastric cancer patients undergoing gastrectomy (2009-2022).
• Comparison of clinicopathological and perioperative parameters, including C-reactive protein on postoperative day 3 (CRPD3) as a surgical trauma indicator.
• Patients stratified by gastrectomy extent (subtotal gastrectomy [STG] or total gastrectomy [TG]) and lymph node dissection (D1+ or D2).

Main Results:

• RPG significantly decreased CRPD3 in the STG with D1+ lymph node dissection (STGD1+) group compared to CPG.
• RPG shortened bowel recovery and hospital stay in STGD1+, STG with D2 dissection (STGD2), and TG with D1+ dissection (TGD1+) groups.
• No significant differences were observed between RPG and CPG in the TG with D2 dissection (TGD2) group.

Conclusions:

• Patients undergoing STGD1+ gastrectomy benefit most from RPG, showing reduced surgical trauma and improved recovery.
• STGD2 and TGD1+ patients also experience significant advantages with RPG.
• RPG is a potentially superior approach for specific gastric cancer surgical candidates.