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Related Experiment Video

Updated: Jun 3, 2025

Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
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Complications Following Open Versus Minimally Invasive Resection of Gastric Adenocarcinoma.

Kelly R Bates1, Whitney Jones1,2, Marjorie R Liggett1

  • 1Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Journal of Surgical Oncology
|January 10, 2025
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Summary

Minimally invasive surgery (MIS) for gastric adenocarcinoma (GA) shows fewer complications than open surgery, but its use has not grown. Sociodemographic factors may influence access to MIS, indicating potential disparities in care.

Keywords:
complicationsgastric adenocarcinomaminimally invasive surgeryopen gastrectomystomach cancersurgical approach

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Health Services Research

Background:

  • Gastric adenocarcinoma (GA) treatment involves open or minimally invasive surgery (MIS), with the optimal approach debated.
  • Current utilization trends and comparative outcomes between open and MIS for GA are not well-defined.

Purpose of the Study:

  • To evaluate the utilization of open versus MIS for GA over time.
  • To compare complication rates and outcomes between open and MIS approaches for GA.
  • To identify predictors associated with experiencing complications or receiving MIS.

Main Methods:

  • Analysis of 4,429 patients undergoing GA resection from 2016-2022 using the American College of Surgeons National Surgical Quality Improvement Program database.
  • Comparison of complication rates, perioperative mortality, and hospital stay duration between open gastrectomy and MIS groups using chi-squared tests.
  • Multivariable Poisson regressions with robust variance were employed to assess predictors of complications and MIS receipt.

Main Results:

  • Open gastrectomy was performed in 84.2% of patients, with MIS utilization remaining stagnant.
  • MIS was associated with significantly lower rates of major complications (13.1% vs. 18.5%), lower perioperative mortality (0.57% vs. 1.53%), and shorter hospital stays (5 vs. 7 days) compared to open surgery.
  • MIS patients had a reduced risk of any complication (RR: 0.7) and non-white patients were less likely to receive MIS.

Conclusions:

  • Minimally invasive surgery (MIS) for gastric adenocarcinoma (GA) is linked to decreased complication risk compared to open gastrectomy.
  • Despite demonstrated benefits, the adoption of MIS for GA has plateaued.
  • Sociodemographic factors appear to influence MIS receipt, suggesting potential healthcare access disparities.