Benefits of minimally invasive surgery in the treatment of gastric cancer

Abstract

We read with great interest the article that retrospectively analyzed 814 patients with primary gastric cancer, who underwent minimally invasive R0 gastrectomy between 2009 and 2014 by grouping them in laparoscopic vs robotic procedures. The results of the study highlighted that age, American Society of Anesthesiologists status, gastrectomy type and pathological T and N status were the main prognostic factors of minimally invasive gastrectomy and showed how the robotic approach may improve long-term outcomes of advanced gastric cancer. According to most of the current literature, robotic surgery is associated with a statistically longer operating time when compared to open and laparoscopic surgery; however, looking at the adequacy of resection, defined by negative surgical margins and number of lymph nodes removed, it seems that robotic surgery gives better results in terms of the 5-year overall survival and recurrence-free survival. The robotic approach to gastric cancer surgery aims to overcome the difficulties and technical limitations of laparoscopy in major surgery. The three-dimensional vision, articulation of the instruments and good ergonomics for the surgeon allow for accurate and precise movements which facilitate the complex steps of surgery such as lymph node dissection, esophagus-jejunal anastomosis packaging and reproducing the technical accuracy of open surgery. If the literature, as well as the analyzed study, offers us countless data regarding the short-term oncological results of robotic surgery in the treatment of gastric cancer, satisfactory data on long-term follow-up are lacking, so future studies are necessary.

I LIVRO DA ABLAC-BR: A Cirurgia Sob as Lentes das Ligas Acadêmicas

“…A laparoscopia possui várias desvantagens e limitações técnicas, que são transponíveis na cirurgia robótica. No entanto, as limitações da cirurgia gástrica robótica se dão pela necessidade de experiência do cirurgião e a implementação técnica do sistema robótico (SIBIO et al, 2022).…”

Short-term outcomes of laparoscopic and robotic distal gastrectomy for gastric cancer

“…The ASA score reflects the severity of preoperative comorbidities. 12,13 It categorizes the risk of surgery based on the patient's preoperative physical condition, and divides the patient into five levels before anesthesia. The higher the level, the greater the surgical risk.…”

Refining molecular subtyping in breast and colon cancers using gene expression and proteomics data

“…Minimally invasive surgery shows benefits when compared to open surgery, like better recurrence-free survival [52]. Alongside, techniques aiding minimally invasive surgery techniques such as three-dimensional vision, instruments' articulation, and greater ergonomics for the surgeon, offer a better therapeutic approach to the minimally invasive treatment [53].…”