stomach_esophagus

Surgeons · Clinics · Programme at Memorial Ataşehir Hospital

• No significant differences were observed in 5-year OS (HR 1.23, 95% CI 0.83-1.84) or RFS (HR 1.36, 95% CI 0.94-1.95). 5-year; Proximal vs. total gastrectomy for proximal advanced gastric cancer after neoadjuvant chemotherapy: a systematic review and meta-analysis of propensity score-matched studies. — Four propensity score-matched (PSM) comparative studies were included in the quantitative meta-analysis, comprising 284 patients undergoing PG and 305 patients undergoing TG after NAC. [9]
• The results of the analysis showed that RATG has advantages in the following aspects: intraoperative blood loss was 17.69 ml lower in the RATG group than in the LATG group (WMD: -17.69,95% CI:-20.90 ∼ -14.49; P < 0.05); In terms of the number of resected lymph nodes, the RATG group had 2.65 more than the LATG group (WMD: 2.65,95% CI:0.88 ∼ -4.42); P < 0.05); the time to start liquid and postoperative hospital stays were 0.62 and 0.90 days shorter in the RATG group than in the LATG group, respectively (WMD: -0.62,95%CI: -1.06 ∼ -0.19; P < 0.05), (WMD: -0.90,95%CI: -1.43 ∼ -0.37; P < 0.05)); the incidence of major complications and pancreas fistula in the RATG group was 0.59% and 0.17% lower than in the LATG group, respectively (OR: 0.59,95% CI: 0.38 ∼ 0.93; P < 0.05), (OR: 0.17,95% CI: 0.03 ∼ 0.94; P < 0.05). 0.90 days; Nine studies that included 1,864 patients with gastric cancer were included, published between 2012 and 2023. [38]
• Surgical approaches (OR 1.03, P = 0.896), positive surgical margins (OR 2.83, P = 0.08), and adjuvant chemotherapy rates (OR 1.07, P = 0.19) were similar between the PG and TG groups. Assessment: surgical specimen margins on tissue examination; Proximal vs. total gastrectomy for proximal advanced gastric cancer: a systematic review and meta-analysis of propensity score-matched studies. — A total of 265 articles were screened, and five retrospective studies were included in this meta-analysis, comprising 412 patients after PSM. [42]

• The overall survival (OS) rate after 1 year was 3.65 times higher for CRS + HIPEC than CRS alone [RR = 3.65, 95% confidence interval (95% CI) = 1.01-13.26, I2 = 73%]. 1 year; Despite promising results, the effectiveness of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with gastric cancer with peritoneal carcinomatosis (GCPC) has not been systematically evaluated. [2]
• The OS rate after 5 years was more than three times higher for CRS + HIPEC than for CRS alone (RR = 3.25, 95% CI = 1.28-8.26, I2 = 8%). 5 years; Despite promising results, the effectiveness of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with gastric cancer with peritoneal carcinomatosis (GCPC) has not been systematically evaluated. [2]
• The 1, 2, 3 and 5-year survival rates (SR) for patients undergoing CRS + HIPEC were 86.9%, 70.5%, 63.7% and 55.7% respectively. 5-year; gastric cancer patients frequently develop peritoneal metastases (PM) with a poor long-term prognosis. [3]

• Survival curves indicated that at 3, 5, and 10 years, the OS rates were 95.9% versus 88.0%, 91.4% versus 78.2%, and 86.7% versus 56.9% for the ASR and non-ASR groups, respectively. 10 years; Long-term outcomes of additional surgical versus nonsurgical treatment after non-curative endoscopic resection for T1 superficial esophageal cancer. — The review identified 15 retrospective studies involving 1348 patients. [4]
• The following outcomes were significantly better in the additional surgery group: 5-year OS (odds ratio [OR] = 3.37, 95% confidence interval [CI] = 2.91-3.91, p < 0.00001; hazard ratio [HR] = 0.51, 95% CI = 0.41-0.64, p < 0.00001), 8-year OS (OR = 1.96, 95% CI = 1.22-3.16, p = 0.005), 5-year DSS (OR = 3.08, 95% CI = 2.08-4.55, p < 0.00001), 5-year DFS (OR = 4.17, 95% CI = 1.53-11.4, p = 0.005), 5-year RFS (OR = 9.14, 95% CI = 3.63-23.01, p < 0.00001), and 5-year CSS (OR = 2.54, 95% CI = 1.32-4.9, p = 0.005). 5-year; 8-year; Debate regarding whether additional surgery should be the preferred treatment option for patients with early gastric cancer who have undergone noncurative endoscopic resection is ongoing. [5]
• There was no significant difference between esophagectomy and ER regarding 5-year OS (HR 1.26; 95% CI 1.00-1.60; P = 0.05), 5-year CSS (HR 0.65; 95% CI 0.20-2.17; P = 0.49), and 30-day mortality (HR 0.39; 95% CI 0.13-1.16; P = 0.09). 5-year; 30-day; We compared patients with T1b esophageal cancer who underwent ER or esophagectomy. [6]

• There was no significant difference between esophagectomy and ER regarding 5-year OS (HR 1.26; 95% CI 1.00-1.60; P = 0.05), 5-year CSS (HR 0.65; 95% CI 0.20-2.17; P = 0.49), and 30-day mortality (HR 0.39; 95% CI 0.13-1.16; P = 0.09). 5-year; 30-day; We compared patients with T1b esophageal cancer who underwent ER or esophagectomy. [6]
• The incidence of recurrent laryngeal nerve (RLN) lymph node metastasis in thoracic esophageal carcinoma ranges from 30% to 50%. Study follow-up: At 5-year follow-up, the multivariate meta-analysis showed similar OS for RLNP vs.; The purpose of the present study was to investigate the influence of RLNP on long-term survival in patients undergoing esophagectomy for cancer. [7]
• No significant differences were found regarding mortality hazard up to 60-month follow-up (HR =0.96; 95% CI: 0.79, 1.10). 60-month; The purpose of the present study was to investigate the influence of RLNP on long-term survival in patients undergoing esophagectomy for cancer. [7]

• For 168 patients who underwent conversion gastrectomy after IP PTX-based regimens, the 1-year OS was 84 % (95 % CI: 77-89). 1-year; Efficacy and safety of intraperitoneal paclitaxel-based regimens in patients with gastric cancer and peritoneal metastasis: A systematic review and meta-analysis. — Among 855 patients, the overall pooled MST with IP PTX-based regimens was 20.2 months. [8]
• No significant differences were observed in 5-year OS (HR 1.23, 95% CI 0.83-1.84) or RFS (HR 1.36, 95% CI 0.94-1.95). 5-year; Proximal vs. total gastrectomy for proximal advanced gastric cancer after neoadjuvant chemotherapy: a systematic review and meta-analysis of propensity score-matched studies. — Four propensity score-matched (PSM) comparative studies were included in the quantitative meta-analysis, comprising 284 patients undergoing PG and 305 patients undergoing TG after NAC. [9]
• RG had longer operative time (WMD: 93.4; 95% CI: 65.89-120.9; P < 0.001) but less blood loss (WMD: -86.71; 95% CI: -120.91–52.52; P < 0.001), shorter hospital stay (WMD: -3.17 days; 95% CI: -4.17–2.16; P < 0.001), lower postoperative complication rate (OR: 0.61; 95% CI: 0.43-0.87; P = 0.006), and higher R0 resection rate (OR: 1.88; 95% CI: 1.57-2.24; P = 0.000). 3.17 days; The value of robot-assisted gastrectomy in the treatment of gastric cancer: a systematic review and meta-analysis. — Seventeen studies involving 31,573 patients (10,524 RG, 21,049 OG) were included. [10]

• About 20% of gastric cancer patients have peritoneal metastases diagnosed preoperatively or intraoperatively, and the median survival time of advanced patients with peritoneal metastases is only 3-6 months, with a 5-year survival rate of less than 2%. 3-6 months; 5-year; About 20% of gastric cancer patients have peritoneal metastases diagnosed preoperatively or intraoperatively, and the median survival time of advanced patients with peritoneal metastases is only 3-6 months, with a 5-year survival rate of less than 2%. [11]
• Meta-analysis showed that the rate of peritoneal metastasis was significantly lower in the HIPEC group than in the control group (OR: 0.24; 95% CI: 0.16-0.35), the rate of distant metastasis was significantly lower in the HIPEC group (OR: 0.45, 95% CI: 0.28-0.71), the 3-year survival rate was prolonged in the HIPEC group compared with the control group (OR: 1.48; 95% CI: 1.01-2.17), the 3-year disease-free survival rate was significantly higher in the HIPEC group (OR: 1.92; 95% CI: 1.23-3.00), and HIPEC was not associated with an increased number of complications and adverse events. 3-year; About 20% of gastric cancer patients have peritoneal metastases diagnosed preoperatively or intraoperatively, and the median survival time of advanced patients with peritoneal metastases is only 3-6 months, with a 5-year survival rate of less than 2%. [11]
• The findings revealed that HIPEC had a higher survival rate (risk ratio [RR] 0.60; 95% confidence interval [CI] [0.43, 0.86], P = 0.005, RR 0.82; 95% CI [0.70, 0.97], P = 0.02, RR 0.83; 95% CI [0.71, 0.96], P < 0.01, and RR 0.63 [0.54, 0.73], P < 0.00001) after 1, 2, 3, and 5 years compared with the control group. 5 years; Gastric cancer patients treated with HIPEC have shown promising outcomes with regard to survival, recurrence, disease-free survival, and adverse reactions. [12]

• The meta-analysis showed that compared with open gastrectomy, patients with GC > 80 years old who underwent laparoscopic gastrectomy had a longer operative time (weighted mean difference [WMD] = 30.48, p < 0.001), less intraoperative blood loss (WMD = -166.96, P < 0.001), shorter postoperative exhaust time (WMD =-0.83, p < 0.001), shorter length of stay (WMD = -0.78, p < 0.001), fewer overall complications (Odds ratio [OR] = 0.54, p = 0.003), higher 5-year overall survival rate (OR = 1.66, p = 0.03) and disease-specific survival rate (OR = 3.23, p < 0.001). 80 years; 5-year; This study aimed to analyse the short-term outcomes and oncological prognosis of laparoscopic gastrectomy in super-elderly patients with gastric cancer (GC). [13]
• Although RG was associated with a longer operative time (MD, 19.82 min), patients may benefit from reduced blood loss (MD, -28.91 mL), shorter length of stay (MD, -0.69 days), lower morbidity (RR, 0.82), major complications (RR, 0.71), blood transfusion rate (RR, 0.60), conversion rate (RR, 0.38), and higher number of harvested lymph nodes (MD, 3.25). 0.69 days; This meta-analysis aimed to compare the short-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for patients with locally advanced gastric cancer using data collected from randomized controlled trials (RCTs) and propensity score-matched (PSM) studies. [14]
• RG significantly reduced overall postoperative complications (OR 0.49, 95% CI 0.26-0.93, P = 0.03), shortened hospital stay (MD – 0.88 days, 95% CI – 1.21 to – 0.55, P < 0.00001), and accelerated bowel function recovery (MD – 0.52 days, 95% CI – 1.00 to – 0.05, P = 0.03) and oral intake (MD – 0.52 days, 95% CI – 1.01 to – 0.03, P = 0.04). 0.88 days; 0.52 days; Robotic versus laparoscopic gastrectomy for gastric cancer: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials on operative metrics, lymphadenectomy, and postoperative complications. — Four RCTs encompassing 919 patients (480 RG, 439 LG) met the inclusion criteria. [15]

• ICG use was associated with significantly improved 1-year (RR = 1.04) and 2-year (RR = 1.09) overall survival, and a greater number of retrieved lymph nodes (MD = 6.00). 1-year; 2-year; This study aims to evaluate the effectiveness and surgical outcomes of ICG-guided laparoscopic lymphadenectomy compared to conventional laparoscopic lymphadenectomy in patients with gastric cancer. [16]
• The actual OS in the SSA group (87.6%) was comparable to that in the SMA group (90.8%, P = 0.41), as were the 3-year actual DFS rates (SSA: 82.9% vs. 3-year; A total of 266 patients with resectable gastric adenocarcinoma (cT1-4a, N0/ +, M0) were enrolled. [17]
• After a 5-year follow-up, the ICG group had a considerably lower cumulative recurrence rate (26/129, 20.2%) than the non-ICG group (44/129, 34.1%) (Gray’s test P = 0.011), with a risk difference of – 0.140. 5-year; METHODS: Participants with resectable gastric adenocarcinoma were randomly allocated in a 1:1 ratio. [18]

• The 5-year OS rate was 93.3% in the LTG group compared to 94.5% in the OTG group, and the 5-year DFS rate was 92.4% in the LTG group compared to 93.6% in the OTG group. 5-year; The long-term survival outcomes for patients with clinical stage I gastric cancer who undergo laparoscopic total gastrectomy (LTG) are still uncertain due to the limited high-level clinical evidence. [19]
• The primary outcome was the morbidity and mortality within 30 days following surgeries between LTG and OTG with a noninferiority margin of 10%. 30 days; The Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) Group CLASS02 study was a prospective, multicenter, open-label, noninferiority, randomized clinical trial that compared the safety of LTG vs OTG with lymphadenectomy for patients with clinical stage I gastric cancer. [20]
• However, 90-day mortality was numerically higher after LTG (7.0% vs 1.4%), and esophagojejunal leakage was significantly more frequent after LTG (15.5% vs 4.2%, p = 0.046).Key surrogate oncological outcomes, including lymph node yield and R0 resection rate, were comparable. 90-day; This single-centre retrospective cohort included 198 consecutive patients who underwent curative-intent total gastrectomy with D2 lymphadenectomy for gastric adenocarcinoma between 2022 and 2025 (LTG, n = 112; OTG, n = 86). [21]

• RG significantly reduced overall postoperative complications (OR 0.49, 95% CI 0.26-0.93, P = 0.03), shortened hospital stay (MD – 0.88 days, 95% CI – 1.21 to – 0.55, P < 0.00001), and accelerated bowel function recovery (MD – 0.52 days, 95% CI – 1.00 to – 0.05, P = 0.03) and oral intake (MD – 0.52 days, 95% CI – 1.01 to – 0.03, P = 0.04). 0.88 days; 0.52 days; Robotic versus laparoscopic gastrectomy for gastric cancer: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials on operative metrics, lymphadenectomy, and postoperative complications. — Four RCTs encompassing 919 patients (480 RG, 439 LG) met the inclusion criteria. [15]
• ICG use was associated with significantly improved 1-year (RR = 1.04) and 2-year (RR = 1.09) overall survival, and a greater number of retrieved lymph nodes (MD = 6.00). 1-year; 2-year; This study aims to evaluate the effectiveness and surgical outcomes of ICG-guided laparoscopic lymphadenectomy compared to conventional laparoscopic lymphadenectomy in patients with gastric cancer. [16]
• ICG slightly reduced blood loss (MD = -26.22 mL; 95 % CI: -49.76 to -2.69; p = 0.04; I2 = 56 %) and length of stay (MD = -0.36 days; 95 % CI: -0.64 to -0.07; p = 0.03; I2 = 0 %), with similar overall complications (RR = 0.92; 95 % CI: 0.79-1.08; p = 0.20; I2 = 0 %). 0.36 days; Indocyanine green-guided lymphadenectomy in gastric cancer after neoadjuvant chemotherapy: A systematic review and meta-analysis. — Five studies involving 694 patients treated with NAT were included, of which 344 used ICG and 350 conventional surgeries. [22]

• Estimated blood loss (MD – 71.78 mL, p < 0.00001), total number of harvested lymph nodes (MD 2.18 nodes, p < 0.0001) and along the left RLN (MD 0.73 nodes, p = 0.03), pulmonary complications (RR 0.70, p = 0.001) and length of hospital stay (MD – 3.03 days, p < 0.0001) are outcomes that favored RAMIE. 3.03 days; The role of robotic surgery in the curative-intent treatment of esophageal cancer patients is yet to be defined. [23]
• RAMIE displayed the lowest 30-day mortality rate at 0.80% (2/250). 30-day; Minimally invasive vs open vs hybrid esophagectomy for esophageal cancer: a systematic review and network meta-analysis. — Seven randomised controlled trials (RCTs) with 1063 patients were included. [24]
• There was no significant difference in 30-day and 90-day mortality between MIE and open esophagectomy [odds ratio (OR) = 0.42, 95% CI (0.09, 2.01); OR 0.80, 95% CI (0.25, 2.60), respectively]. 30-day; 90-day; Overall, MIE could significantly improve the overall survival of patients with esophageal cancer after neoadjuvant therapy compared with open esophagectomy [hazard ratio (HR) = 0.86, 95% confidence interval (CI) (0.75, 0.98)]. [25]

• MIG was associated with higher R0 resection rate (96.5% vs. 92.4% in OG), shorter hospital stay, lower perioperative complication rate (23.0% vs. 31.6%, P<0.001), and reduced 30-day and 90-day mortality rates (1.6% vs. 3.3%, [P=0.026] and 1.9% vs. 4.7%, [P=0.001], respectively). 30-day; 90-day; MIG was performed in patients with smaller tumors, earlier stages, and less frequently receiving neoadjuvant treatment (P<0.001). [26]
• Multivariate analysis revealed that age ≥ 75 years (OR 1.62, 95% CI [1.02-2.60], p = 0.042) and postoperative complications (OR 6.04, 95% CI [3.54-10.32], p < 0.001) were independent risk factors for PD. 75 years; A total of 1476 consecutive patients with gastric cancer undergoing laparoscopic or robotic gastrectomy between 2009 and 2019 at our institution were retrospectively reviewed. [27]
• In patients without complications, TG (OR 1.88) and age of ≥ 75 years(OR 1.71) were determined as independent risk factors. 75 years; A total of 1476 consecutive patients with gastric cancer undergoing laparoscopic or robotic gastrectomy between 2009 and 2019 at our institution were retrospectively reviewed. [27]

• No difference in 3-year survival was observed, this was 57.1% in OTG group versus 46.8% in MITG group (P = 0.186). 3-year; Patients were randomized between OTG and MITG for advanced gastric cancer after neoadjuvant chemotherapy. [28]
• One-year survival was 90.4% in OTG and 85.5% in MITG (p = 0.701). One-year; The incidence of gastric cancer is lower in the Western population and patients often present with more advanced stages of disease. [29]

• There was no significant difference in 30-day and 90-day mortality between MIE and open esophagectomy [odds ratio (OR) = 0.42, 95% CI (0.09, 2.01); OR 0.80, 95% CI (0.25, 2.60), respectively]. 30-day; 90-day; Overall, MIE could significantly improve the overall survival of patients with esophageal cancer after neoadjuvant therapy compared with open esophagectomy [hazard ratio (HR) = 0.86, 95% confidence interval (CI) (0.75, 0.98)]. [25]
• The 5-year OS was 59% (95% CI, 48%-68%) in the HMIE group and 47% (95% CI, 37%-57%) in the open esophagectomy group (hazard ratio [HR], 0.71; 95% CI, 0.48-1.06). 5-year; Eligible patients were 18 to 75 years of age and were diagnosed with resectable cancer of the middle or lower third of the esophagus. [30]
• The combined 5-year overall survival rates for RAMIE and OTE were 41% (95% CI 27-55) and 40% (95% CI 26-53), respectively (log rank test P = 0.827). 5-year; This study is a follow-up study of the ROBOT trial, which was a randomized controlled trial comparing RAMIE to OTE in 112 patients with intrathoracic esophageal cancer. [31]

• Five-year OS (HR 0.95, 95% CI 0.85-1.07) and DFS (HR 0.91, 95% CI 0.79-1.04) did not differ significantly overall; a gastrectomy-type interaction was observed for 5-year OS (P = 0.0041), with imprecise subgroup estimates. 5-year; In selected patients with T4a gastric cancer, LG was associated with similar long-term survival and recurrence outcomes to OG, with faster recovery but more pancreatic fistula. [32]
• The meta-analysis showed that compared with open gastrectomy, patients with GC > 80 years old who underwent laparoscopic gastrectomy had a longer operative time (weighted mean difference [WMD] = 30.48, p < 0.001), less intraoperative blood loss (WMD = -166.96, P < 0.001), shorter postoperative exhaust time (WMD =-0.83, p < 0.001), shorter length of stay (WMD = -0.78, p < 0.001), fewer overall complications (Odds ratio [OR] = 0.54, p = 0.003), higher 5-year overall survival rate (OR = 1.66, p = 0.03) and disease-specific survival rate (OR = 3.23, p < 0.001). 80 years; 5-year; This study aimed to analyse the short-term outcomes and oncological prognosis of laparoscopic gastrectomy in super-elderly patients with gastric cancer (GC). [13]
• LAG was associated with a longer operative time (MD 49.28 minutes; 95% CI 30.88 to 67.69), lower intraoperative blood loss (MD -51.24 milliliters; 95% CI -81.41 to -21.06), shorter length of stay (MD -0.83 days; 95% CI -1.60 to -0.06), and higher incidence of pancreatic fistula (RR 2.44; 95% CI 1.08 to 5.50). 0.83 days; Laparoscopy-assisted gastrectomy (LAG) is a well-established surgical technique in treating patients with early gastric cancer. [33]

• The 5-year OS rate was 93.3% in the LTG group compared to 94.5% in the OTG group, and the 5-year DFS rate was 92.4% in the LTG group compared to 93.6% in the OTG group. 5-year; The long-term survival outcomes for patients with clinical stage I gastric cancer who undergo laparoscopic total gastrectomy (LTG) are still uncertain due to the limited high-level clinical evidence. [19]
• No difference in 3-year survival was observed, this was 57.1% in OTG group versus 46.8% in MITG group (P = 0.186). 3-year; Patients were randomized between OTG and MITG for advanced gastric cancer after neoadjuvant chemotherapy. [28]
• One-year survival was 90.4% in OTG and 85.5% in MITG (p = 0.701). One-year; The incidence of gastric cancer is lower in the Western population and patients often present with more advanced stages of disease. [29]

• The NCO group was associated with the higher 3-year overall survival (OS) rate (RR = 0.95, 95% CI = 0.91-0.99, P = 0.02), 5-year OS rate (RR = 0.91, 95% CI = 0.87-0.96, P = 0.0006), and 5-year relapse-free survival (RFS) rate (RR = 0.93, 95% CI = 0.87-0.99, P = 0.02). 3-year; 5-year; The efficacy of non-complete omentectomy in the radical gastrectomy for gastric cancer: a meta-analysis and systematic review. — Thirteen studies with a total of 4255 patients were included. [34]
• There is no significant difference between the single-port laparoscopic gastrectomy group and the multiport laparoscopic gastrectomy group in mean operation time(MD = 5.23,95% CI:-16.58~27.04,P = 0.64), time to first soft fluid diet(MD=-0.06,95% CI: -0.30~0.18,P = 0.63), time to first flatus(MD=-0.18,95% CI:-0.43~0.07,P = 0.16), early complication(OR = 0.73,95% CI:0.50~1.09,P = 0.12), hospital mortality(OR = 1.00,95% CI:0.09~11.16,P = 1.00), retrieved number of lymph nodes(MD=-1.15, 95% CI:-2.71~0.40, P = 0.15), survival rate after surgery 1 year(OR = 2.14,95% CI:0.50~9.07,P = 0.30), and survival rate after surgery 5 year(93.7 vs. 87.6%; p = 0.689). 1 year; 5 year; To make a high-quality comparison of the short- and long-term outcomes of single-port laparoscopic gastrectomy versus multiport laparoscopic gastrectomy, we performed this meta-analysis, which only included propensity score-matched studies and randomized controlled trials comparing single-port laparoscopic gastrectomy with multiport laparoscopic gastrectomy for patients with gastric cancer. [35]
• In terms of oncological outcomes, the use of ICG could reduce the overall recurrence rate (OR = 0.50; 95% CI 0.28-0.89; P = 0.02) but could not increase the 2-year overall survival rate (OR = 1.25; 95% CI 0.72-2.18; P = 0.43). 2-year; Efficacy of indocyanine green fluorescence imaging-guided lymphadenectomy in radical gastrectomy for gastric cancer: A systematic review and meta-analysis. — 17 studies with a total of 2274 patients (1186 in the ICG group and 1088 in the control group) undergoing radical gastrectomy and lymphadenectomy were included. [36]

• RG had longer operative time (WMD: 93.4; 95% CI: 65.89-120.9; P < 0.001) but less blood loss (WMD: -86.71; 95% CI: -120.91–52.52; P < 0.001), shorter hospital stay (WMD: -3.17 days; 95% CI: -4.17–2.16; P < 0.001), lower postoperative complication rate (OR: 0.61; 95% CI: 0.43-0.87; P = 0.006), and higher R0 resection rate (OR: 1.88; 95% CI: 1.57-2.24; P = 0.000). 3.17 days; The value of robot-assisted gastrectomy in the treatment of gastric cancer: a systematic review and meta-analysis. — Seventeen studies involving 31,573 patients (10,524 RG, 21,049 OG) were included. [10]
• The 5-year overall survival (OS) was 96.7% (95% confidence interval [CI] 91.5-98.7%). 5-year; This single-center, prospective phase II study enrolled patients with clinical stage I gastric cancer undergoing RG. [37]
• The 5-year recurrence-free (RFS) and disease-specific survival (DSS) rates were 96.7% (95% CI 91.5-98.7%) and 99.2% (95% CI 94.3-99.9%), respectively. 5-year; This single-center, prospective phase II study enrolled patients with clinical stage I gastric cancer undergoing RG. [37]

• The results of the analysis showed that RATG has advantages in the following aspects: intraoperative blood loss was 17.69 ml lower in the RATG group than in the LATG group (WMD: -17.69,95% CI:-20.90 ∼ -14.49; P < 0.05); In terms of the number of resected lymph nodes, the RATG group had 2.65 more than the LATG group (WMD: 2.65,95% CI:0.88 ∼ -4.42); P < 0.05); the time to start liquid and postoperative hospital stays were 0.62 and 0.90 days shorter in the RATG group than in the LATG group, respectively (WMD: -0.62,95%CI: -1.06 ∼ -0.19; P < 0.05), (WMD: -0.90,95%CI: -1.43 ∼ -0.37; P < 0.05)); the incidence of major complications and pancreas fistula in the RATG group was 0.59% and 0.17% lower than in the LATG group, respectively (OR: 0.59,95% CI: 0.38 ∼ 0.93; P < 0.05), (OR: 0.17,95% CI: 0.03 ∼ 0.94; P < 0.05). 0.90 days; Nine studies that included 1,864 patients with gastric cancer were included, published between 2012 and 2023. [38]
• In stage III, 3-year DFS was higher in the RTG group (67.4% vs. 54.5%, P = 0.047), but no significant differences were found in 3-year OS or CIR (all P > 0.05). 3-year; Operative safety and oncologic outcomes of robotic and laparoscopic total gastrectomy for advanced middle-upper gastric cancer: a multicenter retrospective study. — This retrospective cohort study included 1099 patients with AMUGC who underwent RTG/LTG at eight high-volume centers in China between 2015 and 2019. [39]

• Uncut Roux-en-Y reconstruction versus Billroth II reconstruction In the realm of surgical complications, very low-certainty evidence suggests that uncut Roux-en-Y reconstruction compared with Billroth II reconstruction may make little to no difference to major postoperative complications (risk ratio (RR) 0.98, 95% confidence interval (CI) 0.24 to 4.05; I² = 0%; risk difference (RD) 0.00, 95% CI -0.04 to 0.04; I² = 0%; 2 studies, 282 participants; very low-certainty evidence) and incidence of anastomotic leakage (RR 0.64, 95% CI 0.29 to 1.44; I² not applicable; RD -0.00, 95% CI -0.03 to 0.02; I² = 32%; 3 studies, 615 participants; very low-certainty evidence). Study follow-up: The follow-up periods for long-term outcomes spanned from 3 months to 42 months, with most studies focusing on a 6- to 12-month range.; Choosing an optimal reconstruction method is pivotal for patients with gastric cancer undergoing distal gastrectomy. [40]
• Uncut Roux-en-Y reconstruction versus Roux-en-Y reconstruction In the realm of surgical complications, very low-certainty evidence suggests that uncut Roux-en-Y reconstruction compared with Roux-en-Y reconstruction may make little to no difference to major postoperative complications (RR 4.74, 95% CI 0.23 to 97.08; I² not applicable; RD 0.01, 95% CI -0.02 to 0.04; I² = 0%; 2 studies, 256 participants; very low-certainty evidence) and incidence of anastomotic leakage (RR 0.34, 95% CI 0.05 to 2.08; I² = 0%; RD -0.02, 95% CI -0.06 to 0.02; I² = 0%; 2 studies, 213 participants; very low-certainty evidence). Study follow-up: The follow-up periods for long-term outcomes spanned from 3 months to 42 months, with most studies focusing on a 6- to 12-month range.; Choosing an optimal reconstruction method is pivotal for patients with gastric cancer undergoing distal gastrectomy. [40]
• There is no significant difference between the proximal gastrectomy with double-tract reconstruction and the total gastrectomy with Roux-en-Y reconstruction group in Early-phase complications(OR = 1.14,95% CI:0.79∼1.64, P = 0.50), Late-phase complications(OR = 1.37,95% CI:0.78∼2.39, P = 0.27), Gastroesophageal reflux symptom evaluation (Visick score)(≥ III)(OR = 0.94,95% CI:0.14∼1.07 P = 0.07), Los Angeles classification(C or D)(OR = 0.33,95% CI:0.01∼8.21, P = 0.50), the 5-year overall survival rates (HR = 1.01, 95% CI: 0.83 ~ 1.23, P = 0.89). 5-year; According to the 5th edition of the Japanese Guidelines for the Treatment of Gastric Cancer, proximal gastrectomy is recommended for patients with early upper gastric cancer who can retain the distal half of the residual stomach after R0 resection. [41]