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Short- and long-term outcomes of laparoscopic or robotic radical gastrectomy based on preoperative perigastric artery CTA surgical decision-making: a high-volume center retrospective study with propensity score matching

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Abstract

Background

Some studies have demonstrated the short-term recovery course for patients who underwent laparoscopic gastrectomy according to preoperative computed tomography angiography (CTA) assessment. However, reports of the long-term oncological outcomes are still limited.

Methods

The data of 988 consecutive patients who underwent laparoscopic or robotic radical gastrectomy between January 2014 and September 2018 were analyzed retrospectively at our center, and propensity score matching was used to eliminate bias. Study cohorts were divided into the CTA group (n = 498) and the non-CTA group (n = 490) depending on whether preoperative CTA was available. The primary and secondary endpoints were the 3-year overall survival (OS) and disease-free survival (DFS) rates and the intraoperative course and short-term outcomes, respectively.

Results

431 patients were included in each group after PSM. Compared with the non-CTA group, the CTA group had more harvested lymph nodes and less operative time, blood loss, intraoperative vascular injury and total cost, especially in the subgroup analysis with BMI ≥ 25 kg/m2 patients. There was no difference in the 3 year OS and DFS between the CTA group and the non-CTA group. When further stratified by BMI < 25 or ≥ 25 kg/m2, the 3-year OS and DFS were significantly higher in the CTA group than in the non-CTA group in terms of BMI ≥ 25 kg/m2.

Conclusions

Laparoscopic or robotic radical gastrectomy based on preoperative perigastric artery CTA surgical decision-making has the possibility of improving short-term outcomes. However, there is no difference in the long-term prognosis, except for a subgroup of patients with BMI ≥ 25 kg/m2.

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Acknowledgements

We would like to thank the participants for their contributions to this study.

Funding

This study was funded by Shandong Provincial Natural Science Foundation, China (Grant No. ZR202103040182); the National Natural Science Youth Foundation of China (Grant No. 82103577).

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China

    Cheng Meng, Shougen Cao, Yulong Tian, Shuai Shen, Xiaodong Liu, Zequn Li, Yu Li, Yuqi Sun, Jianfei Xu, Xingqi Zhang, Ying Kong, Xujie Wang, Hao Yang, Hao Zhong, Zhuoyu Jia & Yanbing Zhou

  2. Shandong Provincial Key Laboratory of Gastrointestinal Tumor Basic and Translational Medicine, Qingdao, China

    Cheng Meng, Shougen Cao, Yulong Tian, Shuai Shen, Xiaodong Liu, Zequn Li, Yu Li, Yuqi Sun, Jianfei Xu, Xingqi Zhang, Ying Kong, Xujie Wang, Hao Yang, Hao Zhong, Zhuoyu Jia & Yanbing Zhou

  3. Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China

    Dongfeng Zhang

  4. Department of Gastrointestinal Surgery, Weifang People’s Hospital, Weifang, China

    Shuai Shen

  5. Department of Gastrointestinal Surgery, Jining People’s Hospital, Jining, China

    Ying Kong

  6. Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai, China

    Xujie Wang

Authors
  1. Cheng Meng
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  2. Shougen Cao
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  7. Yu Li
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  17. Yanbing Zhou
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Contributions

YZ and CM: conceived and designed the study; CM: drafted the manuscript; SC, YT, SS, XL, ZL, YK, and XW: completed data acquisition, data management and statistical analysis; YL, YS, JX, XZ, HY, HZ, ZJ: revised manuscript critically for important intellectual content; DZ: provided great technical assistance throughout the experiment's design and data processing; All authors contributed to this article and approved the submitted version.

Corresponding author

Correspondence to Yanbing Zhou.

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Disclosures

Cheng Meng, Shougen Cao, Yulong Tian, Shuai Shen, Xiaodong Liu, Zequn Li, Yu Li, Yuqi Sun, Jianfei Xu, Xingqi Zhang, Ying Kong, Xujie Wang, Hao Yang, Hao Zhong, Zhuoyu Jia, Dongfeng Zhang, Yanbing Zhou have no conflicts of interest or financial ties to disclose.

Ethical approval

This study was approved by the Affiliated Hospital of Qingdao University ethics review committee (Approval Number QYFYWZLL-26829). All procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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This study was accepted as poster session at the 15th International Gastric Cancer Congress (IGCC 2023), from June 14 to 17, 2023 in Yokohama, Japan.

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Meng, C., Cao, S., Tian, Y. et al. Short- and long-term outcomes of laparoscopic or robotic radical gastrectomy based on preoperative perigastric artery CTA surgical decision-making: a high-volume center retrospective study with propensity score matching. Surg Endosc 37, 6930–6942 (2023). https://doi.org/10.1007/s00464-023-10170-2

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