Japan Digestive Disease Week 2022
International Session (Symposium)3 (JSGS, JSGE)
October 29, 14:30–17:00, Room 4 (Fukuoka International Congress Center Maun Hall)
IS-S3-6_S
Clinical advantage of robotic gastrectomy following preoperative chemotherapy for advanced gastric cancer
- 1
- Department of Surgery, Fujita Health University
- 2
- Advanced Robotic and Endoscopic Surgery, Fujita Health University
【Introduction】
Our previous studies have consistently reported that robotic gastrectomy (RG) for gastric cancer may reduce postoperative complications. However, the safety of RG for advanced gastric cancer (AGC) after preoperative chemotherapy (PCT) remains unclear.
【Methods】
RG was conducted using the double bipolar method based on the concept of the outermost layer-oriented approach. The outcomes of RG for AGC following PCT, including conversion surgery, were retrospectively compared to those of laparoscopic gastrectomy (LG).
【Results】
Between Jan 2010 and Mar 2022, 172 AGC patients underwent PCT followed by gastrectomy (RG, 63; LG, 109). Regarding the patient’s background, cStage [II/III/IV; RG, (9/31/23); LG, (33/58/18); p=0.004], extent of lymphadenectomy [D1+/D2/D2+; RG, (4/55/4); LG, (3/105/1); p=0.038], EG junction cancer (RG, 17.5%; LG, 7.3%; p=0.047), and conversion surgery (RG, 36.5%; LG, 16.5%; p=0.005) were significantly different. RG increased operative time (523 vs. 435 min, p=0.001), however, it reduced morbidity (≧grade3a; 3.2% vs. 17.4%, p=0.007), and hospital stay following surgery (13 vs. 15 days, p=0.007). Regarding long-term outcomes, there were no difference (all Stage; p=0.387, cStageII/III; p=0.827)
【Conclusion】
RG may improve the safety of surgical treatment for AGC following PCT. Further study should be required to confirm the benefit of the prognosis.
Our previous studies have consistently reported that robotic gastrectomy (RG) for gastric cancer may reduce postoperative complications. However, the safety of RG for advanced gastric cancer (AGC) after preoperative chemotherapy (PCT) remains unclear.
【Methods】
RG was conducted using the double bipolar method based on the concept of the outermost layer-oriented approach. The outcomes of RG for AGC following PCT, including conversion surgery, were retrospectively compared to those of laparoscopic gastrectomy (LG).
【Results】
Between Jan 2010 and Mar 2022, 172 AGC patients underwent PCT followed by gastrectomy (RG, 63; LG, 109). Regarding the patient’s background, cStage [II/III/IV; RG, (9/31/23); LG, (33/58/18); p=0.004], extent of lymphadenectomy [D1+/D2/D2+; RG, (4/55/4); LG, (3/105/1); p=0.038], EG junction cancer (RG, 17.5%; LG, 7.3%; p=0.047), and conversion surgery (RG, 36.5%; LG, 16.5%; p=0.005) were significantly different. RG increased operative time (523 vs. 435 min, p=0.001), however, it reduced morbidity (≧grade3a; 3.2% vs. 17.4%, p=0.007), and hospital stay following surgery (13 vs. 15 days, p=0.007). Regarding long-term outcomes, there were no difference (all Stage; p=0.387, cStageII/III; p=0.827)
【Conclusion】
RG may improve the safety of surgical treatment for AGC following PCT. Further study should be required to confirm the benefit of the prognosis.
- Index Term 1: Robotic gastrectomy
- Index Term 2: Preoperative chemotherapy