Outcomes of minimally invasive total gastrectomy and extended lymphadenectomy for treatment of gastric cancer - 05/11/25

Doi : 10.1016/j.amjsurg.2025.116682

Saniya Ablatt ^a,^⁎ , Kiefer Starks ^a, Erik Domas ^a, Deepa Chandhrasekhar ^a, Valerie Du ^a, Tommy Brown ^b
^a Virginia Mason Franciscan Health, 1708 S. Yakima Avenue Suite 115, Tacoma, WA, USA
^b Salish Specialty Services LLC, 3700 Pacific Hwy E Suite 304, Fife, WA, USA

^⁎Corresponding author. Virginia Mason Franciscan Health, 1708 S. Yakima Avenue Suite 112, Tacoma, WA, USA.Virginia Mason Franciscan Health1708 S. Yakima Avenue Suite 112TacomaWAUSA

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Abstract

Introduction

Data regarding outcomes for laparoscopic and robotic total gastrectomy with extended lymph node dissection is lacking. This study presents favorable outcomes for both laparoscopic and robotic total gastrectomy with extended lymphadenectomy in patients with gastric cancer treated at a single-surgeon center.

Methods

A retrospective analysis was conducted on all patients who underwent laparoscopic or robotic total gastrectomy for gastric cancer between January 2017 and January 2023.

Results

26 patients were identified with 7 patients in the laparoscopic cohort and 19 patients in the robotic cohort. Median operative time was 4 h and 45 min. Median length of stay was 7 days. The median number of nodes retrieved was 19.5. Two of the 26 (7.7 %) patients had an esophageal leak managed with esophageal stent placement. There were no deaths within 30 days. Three year survival and five year survival were favorable at 71.4 % and 58.6 %.

Conclusion

Minimally invasive total gastrectomy with extended lymphadenectomy is a safe approach for gastric cancer that results in a low rate of complications and adequate nodal dissection.

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Highlights

•	Laparoscopic and robotic total gastrectomy with extended lymphadenectomy are safe approaches for treatment of gastric cancer.
•	Minimally invasive total gastrectomy achieved the recommended lymph node yield of >16 nodes.
•	Surgeon experience should be a part of decision making regarding minimally invasive technique.

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Keywords : Total gastrectomy, Gastric cancer, Extended lymphadenectomy, minimally invasive surgery, Laparoscopy, Robotics, Surgical oncology