Predictive Factors for Infectious Complications after Robotic Gastrectomy for Gastric or Esophagogastric Junction...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Robotic gastrectomy offers perioperative benefits like reduced blood loss and faster recovery.
• Infectious complications remain a significant concern following robotic gastrectomy.
• Identifying predictive factors for these complications is crucial for optimizing patient care.

Purpose of the Study:

• To identify predictors of postoperative infectious complications in patients undergoing radical robotic gastrectomy.
• To analyze the association between various clinical, nutritional, and surgical factors and infectious complications.

Main Methods:

• Retrospective single-center study of 155 patients with gastric or esophagogastric junction cancer.
• Data collected from December 2017 to April 2025.
• Evaluation of 22 variables, including nutritional indices and surgical factors, to identify predictors of infectious complications.

Main Results:

• Eighteen patients (11.6%) experienced Clavien-Dindo grade II-IIIa infectious complications.
• Predictors identified include current smoking (odds ratio, 3.21) and American Society of Anesthesiologists Physical Status (ASA-PS) class ≥3 (odds ratio, 3.8).
• Lower hemoglobin and lymphocyte-to-monocyte ratios, and higher platelet-to-lymphocyte ratios were observed in patients with complications.

Conclusions:

• Robotic gastrectomy provides technical advantages, but patient-specific risk optimization is vital.
• Preoperative smoking and high ASA-PS class (≥3) are independent predictors of infectious complications.
• Targeted perioperative management for these risk factors may reduce postoperative morbidity.