The extent of resection for proximal third gastric cancer does not influence the clinical outcome. PG and TG have similar survival rates. Both procedures can be accomplished safely. Therefore, PG should be an alternative to TG, even in locally advanced proximal gastric cancers treated by NACT, provided that the tumor size and location permit preservation of adequate remnant of stomach without compromising oncological resection margins. Future QOL studies would further lend credence to the concept of PG for proximal third gastric cancer.

Background Robotic total mesorectal excision (R‐TME) is expected to have advantages over laparoscopic total mesorectal excision (L‐TME). The aim is to compare the short‐term outcomes between initial cases of L‐TME and RTME. Materials and methods Among a total of 168 patients assigned to receive either R‐TME (n = 84) or L‐TME (n = 84), short term outcomes were compared between the groups by 1:1 propensity score matching of eight variables. Results The inter‐sphincteric resection rate (42.9% vs. 25%; P = 0.006) and operative time (372.4 ± 102.8 vs. 301 ± 53.6, P = 0.000) were significantly greater in R‐TME. The conversion rate, blood loss, and length of hospital stay were similar. The anastomotic leak rate and major surgical complications rates were significantly higher in L‐TME (9.5% vs. 1.2%; P = 0.016) and (13.1% vs. 4.8%; P = 0.034) respectively. Conclusion The oncologic quality and short‐term outcomes in the two groups were comparable; however, anastomotic leak rates and major complications were significantly lower in R‐TME. For experienced laparoscopic surgeons, robotic sphincter‐saving TME is associated with lower morbidity when compared with laparoscopic approach.

Minimally invasive approaches can be used safely for total pelvic exenteration in locally advanced lower rectal adenocarcinoma. All patients had fast recovery with less blood loss. In all patients R0 resection was achieved with adequate margins. Long-term oncological outcomes are still uncertain and will require further follow-up.

Background: Minimally invasive surgery (MIS) for pelvic exenteration is not a well-established technique. The aim was to assess the safety and feasibility of MIS for pelvic exenteration in locally advanced primary colorectal cancer and to compare the perioperative outcomes with open surgery. Methods: This is a retrospective analysis of patients, who had undergone pelvic exenteration for primary colorectal adenocarcinoma from May 2013 to July 2018. The shortterm outcomes like perioperative details and histopathological characteristics were compared between the two groups. Results: MIS was performed in 23 patients and open pelvic exenteration was carried out in 72 patients. The mean operative time was significantly more in the MIS group (640 vs. 432 min, p ϭ 0.00). The intraoperative blood loss (900 vs. 1550 ml, p ϭ 0.00) and the requirement for blood transfusion (170 vs. 250 ml, p ϭ 0.03) was significantly less in the MIS group. The overall morbidity (60% vs. 49%, p ϭ 0.306) was comparable between the two groups. The median length of hospital stay in the MIS group was 11 d, compared to 12 d in the open surgery group, (p ϭ 0.634). The rate of R0 resection (87% vs. 89%, p ϭ 0.668) was comparable between the two groups. Conclusion: MIS is feasible and safe for total pelvic exenteration and posterior exenteration in carefully selected locally advanced primary colorectal cancer, when performed by an experienced surgical team in high volume centers. An R0 resection with adequate margin can be achieved with good perioperative outcomes in MIS. Long-term oncological outcomes would require further follow up to confirm.