Robotic and Laparoscopic Total Gastrectomy With D2 Lymphadenectomy for Locally Advanced Gastric Cancer

This study is a prospective, single-center, non-randomized, controlled, non-blind, and non-inferiority observation trial comparing robotic-assisted total gastrectomy with D2 lymph nodal dissection for locally advanced gastric cancer patients with laparoscopic procedure.

Sex

All

Minimum age

18 Years

Maximum age

80 Years

Inclusion Criteria:

1. Pathologically proven gastric adenocarcinoma;
2. Age: older than 18 years old, younger than 80 years old;
3. Tumor located in the upper third of the stomach or esophagogastric junction or other location, and is possible to be curatively resected by total gastrectomy;
4. Preoperative stage of cT2-4aN0-3M0 according to American Joint Committee on Cancer/Union for International Cancer Control 8th edition;
5. American Society of Anesthesiology (ASA) score of class I to III;
6. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
7. Patients who freely give informed consent to participate in the clinical study;

Exclusion Criteria:

1. Early gastric cancer;
2. Age: younger than 18 years old, older than 80 years old;
3. Total gastrectomy with D2 lymphadenectomy was not required;
4. Enlarged or bulky regional lymph node diameter larger than 3 cm based on preoperative imaging;
5. Emergency surgery for gastric cancer-related complications (bleeding or complete obstruction or perforation);
6. Previous upper abdominal surgery (except laparoscopic cholecystectomy);
7. Previous neoadjuvant chemotherapy or radiotherapy for gastric cancer;
8. Unstable angina or myocardial infarction within the past 6 months;
9. Cerebrovascular accident within the past 6 months;
10. American Society of Anesthesiology (ASA) score of class more than III;
11. Severe respiratory disease (FEV1\< 50%);
12. Continuous systemic steroid therapy within 1 month before the study;
13. Pregnant or breast-feeding women;

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