At the recently concluded 97th Annual Meeting of the Japanese Gastric Cancer Association (JGCA) in Nagoya, Japan, the team from The Affiliated Hospital of Qingdao University, led by Professor Yanbing Zhou, participated in key activities, including keynote speeches, presentations, and poster discussions. They shared four clinical research findings spearheaded by Chinese scholars, receiving high praise from the international academic community. This article presents the second part of Professor Zhou’s expert commentary from the event.3. Robotic Gastrectomy: More Suitable for Viscerally Obese Gastric Cancer Patients
Obesity and metabolic syndrome in gastric cancer patients have become a pressing clinical issue. As global obesity rates continue to rise, this phenomenon is increasingly common among gastric cancer patients, presenting unprecedented challenges for clinical treatment. Obese patients often experience compromised cardiopulmonary function, reduced reserves, and decreased tolerance to surgical trauma and anesthesia. Additionally, excess fat tissue in obese patients complicates surgical exposure, making it more difficult to perform precise lymph node dissection, directly increasing the incidence of complications. This prolongs hospitalization, raises medical costs, and significantly impacts postoperative recovery.
At this year’s video seminar, the theme “Digital Innovation in Gastric Cancer Science: Evolution of Robotic Gastrectomy” was discussed. Professor Shougen Cao gave a presentation titled, “Short- and Long-term Comparison of Robotic Versus Laparoscopic Gastrectomy for Visceral Obesity Gastric Cancer Patients,” in which he compared the clinical outcomes of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) in gastric cancer patients with visceral obesity. This retrospective study analyzed data from 590 patients between 2016 and 2019, using propensity score matching (PSM) to eliminate confounding factors.
The results showed that the RG group had significantly lower intraoperative blood loss, a higher number of lymph nodes dissected, shorter postoperative hospital stays, and a lower incidence of surgery-related complications compared to the LG group. Additionally, the RG group demonstrated higher 3-year overall survival (OS) rates. The study indicates that RG is a safe, feasible, and potentially long-term beneficial minimally invasive surgical approach for patients with visceral obesity.
Conference chairs Professor Kazutaka Obama from Kyoto University and Professor Koichi Suda from Fujita Health University commented that this research strongly supports the application of robotic gastrectomy in patients with visceral obesity, showing that it outperforms traditional laparoscopic surgery in both short- and long-term clinical outcomes. This not only promotes the development of minimally invasive surgical techniques but also provides important guidance for clinicians when selecting surgical methods. As technology continues to advance and experience accumulates, robotic surgery is expected to demonstrate its unique advantages across more clinical areas.
4. Preoperative CTA-Based Clinical Decision Making and Surgical Simulation Improve Clinical Outcomes in Obese Patients
At the Digital Innovation in Gastric Cancer Science: Advances in Navigation Surgery session, Dr. Cheng Meng presented on the topic, “Long-term outcomes of preoperative CTA associated with surgical decision-making for laparoscopic gastrectomy: The GISSG20-01 Randomized Clinical Trial” (NCT04636099). This study utilized cutting-edge laparoscopic and robotic surgery technologies, taking a forward-looking and innovative approach to establish a new standard for preoperative gastric vascular classification.
In this study, preoperative CTA technology aided in clinical decision-making and surgical simulation. This technology played a crucial role, especially in the complex surgical scenarios encountered when treating obese patients undergoing laparoscopic or robotic surgery. With the help of CTA, surgeons were able to clearly understand the patient’s gastric vascular conditions prior to surgery, allowing them to plan more precise surgical approaches in advance. This method significantly reduced the risk of vascular injury during laparoscopic and robotic surgeries in obese patients. In the past, the complexity of the gastric vascular network made surgery riskier for obese patients, but CTA allowed surgeons to avoid important blood vessels, significantly lowering the possibility of injury. Additionally, the technology contributed to improving surgical precision, enabling surgeons to better control instruments, perform high-quality lymph node dissections, and ensure accuracy at each step of the procedure. This study aims to build a precise clinical decision-making system to provide more scientific and personalized evidence for gastric cancer surgery planning.
Professor HK Yang commented on the study, emphasizing that its multicenter, randomized controlled trial design effectively validated the value of CTA technology in gastric cancer surgeries for obese patients. Preoperative use of CTA not only optimizes surgical decision-making and improves intraoperative precision, leading to better short-term clinical outcomes, but it also has the potential to positively influence patients’ long-term prognosis. This preoperative evaluation and simulation method, based on imaging, provides more precise navigation for minimally invasive surgeries and is expected to become a standard preoperative procedure for gastric cancer surgeries in obese patients. Furthermore, the study highlights the application potential of digital technologies in the field of gastric cancer surgery.
Professor Yanbing Zhou:Like several institutions in China, we actively participated in this event under the guidance of the Chinese Anti-Cancer Association Gastric Cancer Committee. We prepare thoroughly each year, submitting over a dozen abstracts, with four presentations, including keynote speeches. These covered perioperative management, the ERAS pathway, and prehabilitation of frail elderly patients, among other topics. We also reported on clinical decision-making and surgical simulation based on gastric vascular reconstruction and laparoscopic robotic surgery. Through these exchanges and discussions with both domestic and international experts, I’ve gained invaluable insights. The feedback we received will significantly support our next steps in clinical research and exploration. I sincerely thank Oncology Frontier and many colleagues for their continued attention and support of our team’s clinical research and practice.
Expert Profile
- Distinguished Professor, Qingdao University
- Chief Physician, Doctoral and Postdoctoral Supervisor
- President, Institute of Basic and Translational Research in Gastrointestinal Oncology, Qingdao University
- Vice President, International Hospital, Qingdao University
- Chair of the Department of Surgery and Director of Surgical Education, Qingdao University School of Medicine
- Chief of General Surgery, The Affiliated Hospital of Qingdao University
- Research Fellow in Surgical Oncology, Massachusetts General Hospital, Harvard Medical School
Professor Zhou is a leading figure in the National Key Clinical Specialty for General Surgery and heads the National Health Commission’s Surgical Skills Training Base. With extensive experience in laparoscopic and robotic surgery for gastrointestinal tumors, multidisciplinary treatment, perioperative care, and translational research, he has contributed significantly to advancing clinical practice.
He serves on the editorial board of Annals of Surgery (Chinese edition) and is a manuscript reviewer for high-impact journals such as Surgical Endoscopy, International Journal of Surgery, Science Bulletin, and Gastric Cancer. Professor Zhou is the leading PI of major clinical trials including CLASS14/16, HIPEC09, and GISSG series, and PI of CLASS13, HIPEC01, RESOLVE, and INTRIGUE trials.
- MD, Postdoctoral Fellow at New York University
- Associate Chief of Gastrointestinal Surgery and Deputy Director of Medical Affairs, The Affiliated Hospital of Qingdao University
- Member of the 20th Cohort of the Central Government’s Doctoral Service Program
Academic Positions:
Dr. Cao holds numerous professional roles, including committee positions within the Chinese Medical Association, Chinese Medical Doctor Association, Chinese Anti-Cancer Association, and several provincial-level medical societies. His expertise spans perioperative nutrition, emergency GI surgery, enhanced recovery after surgery (ERAS), and colorectal cancer surgery. He also serves as Chair of the ERAS Committee for the Shandong Medical Workers’ Association and Vice Chair of multiple gastrointestinal and surgical committees in Shandong Province.
- MD, Attending Surgeon, Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University
Dr. Meng has published multiple first-author papers in top-tier journals such as Gastric Cancer, EJSO, and Surgical Endoscopy, as well as leading Chinese medical journals. He has contributed to over 20 SCI-indexed and national journal publications. His research has been selected for oral or special presentations at the 94th, 96th, and 97th JGCA Annual Meetings, the 15th World Congress on Gastric Cancer, and the 17th National Conference on Parenteral and Enteral Nutrition. He also serves as a reviewer for journals including BMC Geriatrics, BMC Surgery, and Scientific Reports.
