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Robotic Subtotal Gastrectomy with Small Remnant Stomach for Gastric Cancer in the Upper Stomach

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Journal of Gastrointestinal Surgery

Abstract

Background

Robotic subtotal gastrectomy (RsTG) with a small remnant stomach for treatment of gastric cancer (GC) in the upper stomach may have advantages over robotic TG (RTG). These may affect postoperative complications and postoperative nutritional status.

Methods

This is a single-center retrospective study of 46 consecutive patients with GC who underwent RsTG (n = 10) and RTG (n = 36). The indication for RsTG included tumor located in the upper body of the stomach, in which the distance between the upper edge of the tumor and the junction was 2 cm or more and less than 5 cm, and no clinical evidence of lymph node metastasis.

Results

Operation time was significantly longer (384 min) and intraoperative blood loss was significantly larger (38 ml) in the RTG group than in the RsTG group (299.5 min, P = 0.021, and 25 ml P = 0.002). Two patients (5.6%) in the RTG group had complications, while no postoperative complications of higher than grade II were observed in the RsTG group. Serum albumin levels at 3 months after surgery were significantly higher in the RsTG group (3.85 g/dl) than in the RTG group (3.2 g/dl, P = 0.001). Postoperative recovery of bodyweight at 6 months after surgery was significantly better in the RsTG group (91.3%) than in the RTG group (84.25%, P = 0.001).

Conclusion

RsTG for treatment of patients with GC in the upper body of the stomach is safe and feasible, and may enable improved postoperative nutritional status compared with RTG.

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Acknowledgements

We acknowledge proofreading and editing by Benjamin Phillis at the Clinical Study Support Center, Wakayama Medical University.

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Authors and Affiliations

  1. Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan

    Toshiyasu Ojima, Masaki Nakamura, Keiji Hayata, Junya Kitadani, Akihiro Takeuchi & Hiroki Yamaue

Authors
  1. Toshiyasu Ojima
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  2. Masaki Nakamura
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  3. Keiji Hayata
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  4. Junya Kitadani
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  5. Akihiro Takeuchi
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  6. Hiroki Yamaue
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Contributions

Study concept and design: Ojima and Yamaue.

Acquisition of data: Ojima, Nakamura, Hayata, Takeuchi and Kitadani.

Analysis and interpretation of data: Ojima, Nakamura and Hayata.

Drafting of the manuscript: Ojima, Nakamura and Kitadani.

Critical revision of the manuscript for important intellectual content: Yamaue.

Statistical analysis: Ojima, Hayata and Yamaue.

Administrative, technical and material support: Nakamura, Hayata, Kitadani, Takeuchi and Yamaue.

Study supervision: Yamaue.

Corresponding author

Correspondence to Toshiyasu Ojima.

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The authors declare no competing interests.

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Ojima, T., Nakamura, M., Hayata, K. et al. Robotic Subtotal Gastrectomy with Small Remnant Stomach for Gastric Cancer in the Upper Stomach. J Gastrointest Surg 25, 2165–2171 (2021). https://doi.org/10.1007/s11605-021-05025-x

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  • DOI: https://doi.org/10.1007/s11605-021-05025-x

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