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

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.

Automated summary

This single-center retrospective study compared outcomes of robotic subtotal gastrectomy (RsTG) and robotic total gastrectomy (RTG) in treating gastric cancer patients. RsTG had shorter operation time, less intraoperative blood loss, lower complication rate, higher serum albumin levels, and better postoperative bodyweight recovery compared to RTG.