ArticleJournal of surgical oncology2025
Risk of Open Conversion During Robotic Gastrectomy for Gastric Cancer: Optimizing Patient Selection.
Article in Journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Comparative Analysis of Short- and Long-Term Surgical Outcomes Following Open Conversion from Laparoscopic and Robotic Gastrectomy in Patients with Gastric Cancer.Journal of clinical medicine · 2026Article
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Authors and funding
13 authors.
Funding
Abstract
BACKGROUND AND
objectivesRobotic surgery for gastric adenocarcinoma (GC) shows recovery benefits compared to open and laparoscopic approaches. While open conversion (OC) is associated with poorer outcomes, factors influencing robotic gastrectomy (RG) OC are obscure. We identified preoperative and intraoperative risk factors for OC and associated outcomes.
methodsWe performed a retrospective analysis of RG using a prospectively maintained GC database from a high-volume comprehensive US cancer center between January 2010 and October 2022. RG standardization began in July 2015, with ongoing expansion of patient selection criteria. Patients who underwent radical resection with biopsy-proved GC were included in the analysis if the operation was initiated robotically. Preoperative documentation of likely to convert to open procedures was identified.
resultsOf 289 gastrectomy cases, 133 (46.0%) were RG. Before RG standardization, OC rate was 42.1% (n = 8/19); then decreased to 15.8% (n = 18/114). Factors causing unplanned OC included instability upon insufflation (7.7%), difficult esophagojejunostomy (23.1%), bulky nodes (26.9%), and tumor invasion/fibrosis (38.5%). On multivariate analysis, Preoperative EUS (OR 0.78) decreased OC likelihood, whereas prior abdominal surgeries (OR 1.31) increased OC likelihood (p < 0.05). D2 lymphadenectomy and neoadjuvant treatment did not increase OC likelihood.
conclusionsPre-operatively identifiable OC factors can guide RG patient selection. Yet, certain intraoperative findings challenge RG and require improved preoperative planning.
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