Assessment of laparoscopic indocyanine green tracer-guided lymphadenectomy after neoadjuvant chemotherapy for locally advanced gastric cancer. A randomized controlled trial.

Xie D, Shen J, Liu L, Cao B, Xiao A, Qin J et al.

Br J Surg 2024; 111: znae106.

In this study that included 169 patients, the addition of complete mesogastric excision improved 3-year disease-free survival (85 versus 75.5 per cent, P=0.042), but not quite overall survival (85.8 versus 77.5 per cent, P=0.058).

Comment: It remains unknown whether this makes a big enough difference.

Chao Y-K, Li Z, Jiang H, Wen Y-W, Chiu C-H, Li B et al.

Br J Surg 2024; 111: znae143.

This study included 203 patients with tumour lymph nodes near the recurrent laryngeal nerve. Successful removal of lymph nodes adjacent to the nerve was more likely with robotic dissection (88.3 versus 69 per cent video-assisted, P<0.001). The rate of recurrent laryngeal nerve palsy after surgery was also reduced by robotic dissection: 20.4 versus 34 per cent, P=0.029.

Comment: Surgery was more accurate with the robot, with reduced recurrent laryngeal nerve damage.

Kikuchi S, Matsusaki T, Mitsuhashi T, Kuroda S, Kashima H, Takata N et al.

BJS Open; 8: zrad161.

Pain scores at rest 48h after surgery were lower after epidural (1.94 versus 2.63, P=0.043) in this study that included 129 procedures.

Comment: Epidural remains optimal.