Academic Journal
Robotic vs laparoscopic gastrectomy after neoadjuvant chemotherapy in overweight and obese patients with gastric cancer: a propensity score-matched analysis.
| Τίτλος: | Robotic vs laparoscopic gastrectomy after neoadjuvant chemotherapy in overweight and obese patients with gastric cancer: a propensity score-matched analysis. |
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| Συγγραφείς: | Meng C; Department 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., Cao S; Department 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., Liu Q; Department 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., Zhou Y; Department 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., Li Z; Department 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; Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN, United States. Electronic address: lizequn@qdu.edu.cn. |
| Πηγή: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2026 Oct; Vol. 30 (10), pp. 102515. Date of Electronic Publication: 2026 Aug 12. |
| Τύπος έκδοσης: | Journal Article; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 9706084 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4626 (Electronic) Linking ISSN: 1091255X NLM ISO Abbreviation: J Gastrointest Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2024-: [Amsterdam] : Elsevier B.V. Original Publication: St. Louis, MO : Quality Medical Pub., c1997- |
| Ιατρικοί όροι (MeSH): | Stomach Neoplasms*/surgery , Stomach Neoplasms*/complications , Stomach Neoplasms*/drug therapy , Stomach Neoplasms*/therapy , Stomach Neoplasms*/mortality , Gastrectomy*/methods , Laparoscopy*/methods , Robotic Surgical Procedures*/methods , Obesity*/complications , Overweight*/complications, Humans ; Neoadjuvant Therapy ; Female ; Retrospective Studies ; Middle Aged ; Propensity Score ; Male ; Aged ; Operative Time ; Chemotherapy, Adjuvant ; Treatment Outcome |
| Περίληψη: | 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. (Copyright © 2026 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare no competing interests. |
| Contributed Indexing: | Keywords: Gastric cancer; Laparoscopic gastrectomy; Neoadjuvant chemotherapy; Overweight and obesity; Robotic gastrectomy |
| Entry Date(s): | Date Created: 20260812 Date Completed: 20260930 Latest Revision: 20260930 |
| Update Code: | 20261001 |
| DOI: | 10.1016/j.gassur.2026.102515 |
| PMID: | 42586232 |
| Βάση Δεδομένων: | MEDLINE |
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