{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:14:08Z","timestamp":1786115648977,"version":"build-2736575974"},"reference-count":19,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health and Welfare","award":["RS-2025-02303388"],"award-info":[{"award-number":["RS-2025-02303388"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objective: Laparoscopic gastrectomy (LG) and robotic gastrectomy (RG) exhibit similar surgical outcomes in patients with gastric cancer (GC), except for the higher cost associated with RG. Comparative surgical outcome studies after open conversion from laparoscopic (OL) and robotic (OR) gastrectomy in GC are limited. This study aimed to evaluate clinical effectiveness while considering differences in procedural cost. Methods: This retrospective cohort study included a comparative analysis of patients with GC who underwent OL or OR. Inclusion criteria were histologically confirmed adenocarcinoma and curative resection for GC using OL or OR. Exclusion criteria included initially planned open surgery and other laparoscopic or robotic procedures without gastrectomy. Clinicopathological characteristics, as well as short- and long-term surgical outcomes, were compared between groups. Results: Overall, 118 (1.9%) of 6336 LG cases and 10 (2.6%) of 384 RG cases were included (p = 0.3308). Clinicopathological characteristics were statistically comparable between groups. Postoperative complication incidence, evaluated using the Clavien\u2013Dindo classification, was 19.5% and 10% in the OL and OR groups, respectively (p &gt; 0.05). The median hospital stay was 8 and 9.5 days in the OL and OR groups, respectively (p &gt; 0.05). Reasons for open conversion were similar between groups and included adhesion, bleeding, advanced disease, and positive resection margins, among others. Overall 5-year survival was 0.79 (0.72\u20130.88) and 0.88 (0.67\u20131.0) in OL and OR, respectively (p = 0.596). Conclusions: Short- and long-term surgical outcomes after OL and OR did not differ statistically. Selection of LG versus RG should be performed with caution.<\/jats:p>","DOI":"10.3390\/jcm15156036","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:16:27Z","timestamp":1785766587000},"page":"6036","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Analysis of Short- and Long-Term Surgical Outcomes Following Open Conversion from Laparoscopic and Robotic Gastrectomy in Patients with Gastric Cancer"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3220-7557","authenticated-orcid":false,"given":"Mahmoud","family":"Hemdan","sequence":"first","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, Goyang 10408, Republic of Korea"},{"name":"Surgical Oncology Department, Maadi Military Medical Complex, Cairo 4211220, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Biostatistics Collaboration Team, Research Institute, National Cancer Center, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6252-7532","authenticated-orcid":false,"given":"Sang Soo","family":"Eom","sequence":"additional","affiliation":[{"name":"Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Shick","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2201-9434","authenticated-orcid":false,"given":"Woo Jun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bang Wool","family":"Eom","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Man","family":"Yoon","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keun Won","family":"Ryu","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4","DOI":"10.5230\/jgc.2026.26.e13","article-title":"Epidemiology of gastric cancer in Korea (1999\u20132022): Incidence, survival, and 5-year conditional relative survival","volume":"26","author":"Park","year":"2026","journal-title":"J. Gastric Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.5230\/jgc.2025.25.e11","article-title":"Korean practice guidelines for gastric cancer 2024: An evidence-based, multidisciplinary approach (update of 2022 guideline)","volume":"25","author":"Kim","year":"2025","journal-title":"J. Gastric Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1002\/bjs.8887","article-title":"Surgical stress after robot-assisted distal gastrectomy and its economic implications","volume":"99","author":"Park","year":"2012","journal-title":"Br. J. Surg."},{"key":"ref_5","first-page":"1004","article-title":"Short- and long-term outcomes of conversion in laparoscopic gastrectomy for gastric cancer","volume":"23","author":"Ding","year":"2018","journal-title":"J. BUON"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1002\/jso.70032","article-title":"Risk of open conversion during robotic gastrectomy for gastric cancer: Optimizing patient selection","volume":"132","author":"Chen","year":"2025","journal-title":"J. Surg. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"American Society of Anesthesiologists (2025). American society of anesthesiologists statement on ASA physical status classification system. Anesthesiol. Open, 1.","DOI":"10.1097\/ao9.0000000000000002"},{"key":"ref_8","first-page":"93","article-title":"The Eighth Edition AJCC cancer staging manual: Continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J. Clin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1007\/s00464-018-06648-z","article-title":"Robotic Gastrectomy versus laparoscopic Gastrectomy for Gastric Cancer: Meta-Analysis and Trial Sequential Analysis of Prospective Observational Studies","volume":"33","author":"Bobo","year":"2019","journal-title":"Surg. Endosc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.jss.2022.05.017","article-title":"Predictors of conversion during minimally invasive gastrectomy for malignancy","volume":"279","author":"Stahl","year":"2022","journal-title":"J. Surg. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1186\/s12957-020-01888-7","article-title":"Laparoscopic versus Open Approach in Gastrectomy for Advanced Gastric Cancer: A Systematic Review","volume":"18","author":"Zhu","year":"2020","journal-title":"World J. Surg. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1001\/jamasurg.2022.6337","article-title":"Cost-effectiveness of laparoscopic vs open gastrectomy for gastric cancer: An economic evaluation alongside a randomized clinical Trial","volume":"158","author":"Seesing","year":"2023","journal-title":"JAMA Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ielpo, B., Podda, M., Burdio, F., Sanchez-Velazquez, P., Guerrero, M.-A., Nu\u00f1ez, J., Toledano, M., Morales-Conde, S., Mayol, J., and Lopez-Cano, M. (2022). Cost-Effectiveness of Robotic vs. Laparoscopic Surgery for Different Surgical Procedures: Protocol for a Prospective, Multicentric Study (ROBOCOSTES). Front. Surg., 9.","DOI":"10.3389\/fsurg.2022.866041"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s13304-020-00958-5","article-title":"Current status of robotic gastrectomy for gastric cancer: Comparison with laparoscopic gastrectomy","volume":"73","author":"Kim","year":"2021","journal-title":"Updates Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"142","DOI":"10.7602\/jmis.2024.27.3.142","article-title":"Analyzing the emergence of surgical robotics in Africa: A scoping review of pioneering procedures, platforms utilized, and outcome meta-analysis","volume":"27","author":"Falola","year":"2024","journal-title":"J. Minim. Invasive Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1001\/jamaoncol.2018.6727","article-title":"Effect of laparoscopic distal gastrectomy vs open distal gastrectomy on long-term survival among patients with Stage I gastric cancer: The KLASS-01 randomized clinical Trial","volume":"5","author":"Kim","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3304","DOI":"10.1200\/JCO.20.01210","article-title":"Long-term outcomes of laparoscopic distal gastrectomy for locally advanced gastric cancer: The KLASS-02-RCT randomized clinical Trial","volume":"38","author":"Hyung","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1097\/SLA.0000000000003217","article-title":"Short-term outcomes of a multicenter randomized controlled trial comparing laparoscopic distal gastrectomy with D2 lymphadenectomy to open distal gastrectomy for locally advanced gastric cancer (KLASS-02-RCT)","volume":"270","author":"Lee","year":"2019","journal-title":"Ann. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6036\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:26:50Z","timestamp":1785990410000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/6036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":19,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15156036"],"URL":"https:\/\/doi.org\/10.3390\/jcm15156036","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]}}}