Related Experiment Video
Updated: Aug 14, 2026
Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer
Published on: October 31, 2025
Robotic vs laparoscopic gastrectomy after neoadjuvant chemotherapy in overweight and obese patients with gastric
Cheng Meng1, Shougen Cao1, Qi Liu1
1Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China; Gastrointestinal Tumor Translational Medicine Research Institute of Qingdao University, Qingdao, Shandong Province, China.
Purpose:
Evidence comparing robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) in overweight and obese patients with gastric cancer after neoadjuvant chemotherapy (NACT) remains limited. This study compares perioperative outcomes in this technically demanding setting.
Methods:
We conducted a retrospective single-center study using a prospectively maintained database. Patients with a body mass index ≥ 25 kg/m² who underwent RG or LG after NACT between January 2018 and December 2022 were reviewed. A total of 91 patients were included in the analysis after matching (47 in the RG group and 44 in the LG group). Intraoperative, postoperative, and oncologic outcomes were compared between the 2 groups.
Results:
After matching, RG was associated with a shorter operative time (233.6 vs 276.6 min; P =.003), less blood loss (44.0 vs 70.8 mL; P <.001), a greater total lymph node yield (34.3 vs 30.5; P =.002) and a greater yield in the suprapancreatic area (13.2 vs 10.6; P =.007), faster bowel recovery (3.0 vs 3.7 days; P <.05), earlier liquid intake (3.1 vs 3.9 days; P <.05), a shorter postoperative stay (7.9 vs 11.1 days; P <.05), and lower overall and surgical morbidity (12.8% vs 31.8%; P =.028% and 4.3% vs 22.7%; P =.009). The 5-year overall survival and recurrence-free survival were comparable between the groups (both P >.05). Site-specific recurrence-free survival analyzes also showed no significant differences between groups.
Conclusion:
In overweight and obese patients with gastric cancer who undergo gastrectomy after NACT, RG is associated with improved perioperative outcomes. The robotic approach may be particularly useful when minimally invasive gastrectomy is technically demanding, although long-term oncologic outcomes should be interpreted cautiously.
