Assessment of Robotic Versus Laparoscopic Gastrectomy for GC Patients With Intraoperative Technical Complexity

Assessment of Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer Patients With Intraoperative Technical Complexity: A Multicenter Retrospective Study

While robotic gastrectomy (RG) is increasingly used in gastric cancer surgery, its potential advantages over laparoscopic gastrectomy (LG) in Intraoperative technical complexity (ITC) cases remain debated.

This retrospective cohort study included 3,534 patients with gastric cancer who underwent radical gastrectomy at eight high-volume hospitals. ITC was defined by any of the following criteria: operative time exceeding the third quartile, intraoperative estimated blood loss ≥ 400 mL, or conversion to open surgery. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were conducted to compare short- and long-term outcomes.

Inclusion Criteria:

• Patients with postoperatively histologically confirmed T1-4aN0-3bM0 gastric adenocarcinoma who underwent RG or LG

Exclusion Criteria:

• Remnant gastric cancer
• Previous malignant
• ASA class >3
• Use of indocyanine green
• Neoadjuvant chemotherapy
• Loss to follow-up
• Combined resection