Robotic total gastrectomy for gastric cancer in Italy: clinical and oncological results from the IMIGASTRIC database

The aim of this study was to evaluate the impact of the robotic approach during total gastrectomy for gastric cancer patients in Italy. A multi-institutional database was used. Data were extracted from the IIMIGASTRIC database, a tailored web-based international system for gastric cancer patients. Robotic approach, italian centers and total gastrectomy were among the inclusion criteria. Descriptive information of patients, tumor and procedures were summarized. Operative results, data on the postoperative course and assessment of complications were based on the following primary outcomes: estimated blood loss (EBL), retrieved lymphnodes, hospital stay, in-hospital complications (number, type), readmission. Oncological follow-up was analyzed. Data of 125 patients were extracted and analyzed. 69.6% of cases underwent surgery for advanced gastric cancer. The mean operative time was 335.46±84.5min; EBL was 93.91±69.4mL. D2 lymphadenectomy was performed in 96% of patients, the conversion rate was 5.6%. Mean hospital stay was 8.77±6.5 days. Patients had the following main post-operative complications: anastomosis leakage (4%), anastomotic stenosis (0.8%), bleeding (0.8%). The rate of reoperation for complication was 2.4%. Total gastrectomy is a technical demanding procedure. The robotic approach allows surgeons to overcome some limitations experienced during traditional laparoscopy and particularly when performing a D2 procedure in advanced gastric cancers or in challenging reconstructions.