PD1040 - ROBOTIC VERSUS LAPAROSCOPIC GASTRECTOMY AFTER NEOADJUVANT CHEMOTHERAPY IN OVERWEIGHT AND OBESE GASTRIC CANCER

PD1040

ROBOTIC VERSUS LAPAROSCOPIC GASTRECTOMY AFTER NEOADJUVANT CHEMOTHERAPY IN OVERWEIGHT AND OBESE GASTRIC CANCER

Z. Li^1,*, C. Meng¹, Y. Zhou¹

¹Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China

Rationale: In overweight and obese patients, neoadjuvant chemotherapy may increase the technical difficulty of gastrectomy and delay postoperative recovery. We compared robotic and laparoscopic gastrectomy in this high-risk group, with emphasis on perioperative recovery. 

Methods: We retrospectively analyzed gastric cancer patients with body mass index at least 25 kg/m2 who underwent minimally invasive radical gastrectomy after neoadjuvant chemotherapy. Propensity score matching generated 47 well-balanced pairs. Intraoperative outcomes, postoperative recovery, complications, and survival were assessed. 

Results: After matching, robotic gastrectomy had shorter operative time (233.6 vs 280.7 min; P<0.05), lower blood loss (44.0 vs 74.4 mL; P<0.05), more total harvested lymph nodes (34.3 vs 30.7; P<0.05), and more suprapancreatic lymph nodes (13.2 vs 10.6; P<0.05). Recovery was faster after robotic surgery, including earlier bowel function recovery (3.0 vs 3.7 days; P<0.05), earlier oral intake (3.1 vs 3.8 days; P<0.05), and shorter hospital stay (7.9 vs 10.4 days; P<0.05). Overall complications (12.8% vs 29.8%) and surgical complications (4.3% vs 19.1%) were lower. Five-year recurrence-free survival was higher after robotic surgery (66.0% vs 51.1%; P=0.047), whereas overall survival was comparable. 

Conclusion: In overweight and obese gastric cancer patients after neoadjuvant chemotherapy, robotic gastrectomy was associated with faster postoperative recovery, fewer complications, and improved recurrence-free survival versus laparoscopy. 

Disclosure of Interest: None declared