210: SHORT-TERM RESULTS AFTER ROBOTIC SURGERY FOR GASTRIC CANCER: A SINGLE-CENTER, PROSPECTIVE STUDY

Abstract

Abstract Background and aim Gastric cancer is the fifth most frequent cancer globally. The mainstay of curative treatment is surgical resection with or without (neo)adjuvant therapy. Minimally invasive surgery for gastric cancer was introduced as to reduce post-operative morbidity and hospital length of stay. While the role of laparoscopic gastrectomy has been definitively established, only recently robotic gastric surgery has been gaining increasing application. This is mainly due to the assumption that robotic technology can overcome some of the technical limitations of conventional laparoscopic. The purpose of this study was to assess the feasibility and safety of robotic gastrectomy for gastric cancer and report the short-term results of a single-center prospective study. Methods From April 2017 to June 2020, 103 consecutive patients underwent robotic gastrectomy by a single surgeon at the Digestive Surgery Unit, Careggi University Hospital. There were 57 males and 46 females. The median age was 72 years (range 44–90). Seventy nine distal and 24 total gastrectomies were performed. A D2 lymphadenectomy was performed in all the patients. Tumors were staged as follows: 32 (31.0%) were stage I, 18 (17.5%) stage II and 53 (51.5%) stage III. Results The mean operative time was 323 (range: 250–525) and 445 (range:155–555) minutes for distal and total gastrectomy, respectively. There were no intraoperative complications and no conversions to laparoscopic or open surgery occurred. The rate of postoperative morbidity was 14.1% while no postoperative 30-day mortality was registered. Overall, 5 patients required reintervention. All patients received R0 resection. The mean total number of harvested lymph nodes was 45.6 (range: 18–112). A significant increase in the number of examined lymph nodes was observed during the learning curve (Figure 1). In particular, the mean values were 34.7 during the initial learning phase (case 1–25), 48.7 during the proficiency phase (case 26–88) and 50.4 during the mastery phase (case 89–103). Conclusion Our findings demonstrate the safety and the oncological adequacy of the robotic approach in the treatment of gastric cancer. However, further randomized clinical trials are required to confirm our results.