Outcomes of Minimally Invasive Versus Open Gastrectomy for Gastric Cancer Surgery With Curative Intent: A...

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Minimally Invasive Surgery

Background:

• Limited evidence exists on the short- and long-term outcomes of minimally invasive gastrectomy (MIG).
• Comparing MIG with traditional open gastrectomy (OG) is crucial for establishing best practices in gastric cancer treatment.

Purpose of the Study:

• To compare postoperative events and oncologic results between minimally invasive gastrectomy (MIG) and open gastrectomy (OG).
• To evaluate the safety and efficacy of MIG in gastric cancer surgery.

Main Methods:

• A population-based cohort study analyzed 1,333 matched-pair patients undergoing elective gastric cancer resection (2014-2021).
• Propensity score matching (1:1) compared MIG and OG groups for complications, 90-day mortality, and survival (OS, DFS).
• Subtotal (SG) versus total gastrectomy (TG) outcomes were also assessed.

Main Results:

• MIG use increased significantly from 2017.
• MIG and OG demonstrated similar rates of overall complications, major complications, 90-day mortality, and failure to rescue.
• MIG resulted in significantly shorter hospitalizations and higher lymph node retrieval (≥15 nodes).
• Five-year overall survival (OS) and disease-free survival (DFS) were comparable between MIG and OG.

Conclusions:

• Implementation of minimally invasive gastrectomy (MIG) is safe and does not increase complications.
• MIG achieves similar oncologic outcomes to open gastrectomy (OG) for gastric cancer patients.
• MIG offers potential benefits such as reduced hospital stay.