Evidence map›Paper›PMID 40976808›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2025

Minimally invasive versus open completion total gastrectomy for remnant gastric cancer: a nationwide propensity score-matched analysis.

Nobuhiro Nakazawa, Takashi Sakamoto, Hiroyuki Yamamoto, Akihiko Sano, Makoto Sakai, Shingo Kanaji, Hirotoshi Kikuchi, Hideki Ueno, Ken Shirabe, Hiroshi Saeki

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Nobuhiro NakazawaDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Takashi SakamotoDepartment of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.
Hiroyuki YamamotoDepartment of Healthcare Quality Assessment, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Akihiko SanoDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Makoto SakaiDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Shingo KanajiProject Management Subcommittee, The Japanese Society of Gastroenterological Surgery, Minato-ku, Tokyo, Japan.
Hirotoshi KikuchiProject Management Subcommittee, The Japanese Society of Gastroenterological Surgery, Minato-ku, Tokyo, Japan.
Hideki UenoDatabase Committee, The Japanese Society of Gastroenterological Surgery, Minato-ku, Tokyo, Japan.
Ken ShirabeDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Hiroshi SaekiDepartment of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan. h-saeki@gunma-u.ac.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinimally invasive surgery (MIS) is increasingly used for gastric cancer; however, its application to remnant gastric cancer (RGC) remains technically challenging due to adhesions and altered anatomy. Large-scale comparative data on the safety and effectiveness of MIS versus open surgery for RGC are limited. This retrospective study aimed to evaluate the short-term outcomes of MIS versus open completion total gastrectomy for RGC.

methodsWe retrospectively analyzed data from 3337 patients who underwent completion total gastrectomy for RGC between January 2018 and December 2022 using the National Clinical Database of Japan. After applying predefined inclusion criteria, we performed one-to-one propensity score matching to balance baseline characteristics between the MIS and open surgery groups and compared short-term surgical outcomes.

resultsAfter matching, 540 patient pairs were included in the analysis. MIS was associated with a significantly longer operative time (median 344 vs. 248.5 min; P < 0.001) but reduced blood loss (median 70 vs. 290 mL; P < 0.001). The incidence of anastomotic leakage was higher in the MIS group (9.8% vs. 6.3%; P = 0.034). Postoperative hospital stay was numerically shorter in the MIS group (median 13 vs. 14 days; P = 0.065). Overall complication, reoperation, and mortality rates were comparable between groups.

conclusionsMIS for RGC showed comparable short-term outcomes to those of open surgery in a nationwide analysis, with advantages including reduced blood loss. However, the increased risk of anastomotic leakage highlights the need for careful patient selection and ongoing technical refinement.

Indexed as

GastrectomyGastric StumpMinimally Invasive Surgical ProceduresStomach NeoplasmsAgedFemaleHumansJapanLaparoscopyLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsPropensity ScoreRetrospective StudiesMinimally invasive surgeryNational clinical databasePropensity score matchingRemnant gastric cancerShort-term outcomes

Identifiers

PMID40976808

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.