Robotic surgical system completed radical gastrectomy for gastric cancer after liver transplantation: case report and systematic review

De novo gastric cancer (GC) is uncommon in clinic after liver transplantation. Until now, only a few cases have been reported, and radical resection combined with comprehensive treatment remains the major therapeutic method. Two patients with De novo GC after liver transplantation were successfully treated with D2 lymphadenectomy using da Vinci robotic surgery system at our Hospital. Both operations were successful, and the duration of case 1 and 2 was 315 and 275 minutes respectively, with the estimated blood loss of 145 and 125 mL. The patients were discharged on day 7 and 9 after surgery, and no complications occurred. Postoperative pathological stages were pT4aN3aM0, stage III B and pT4aN2M0, stage III A respectively. Case 2 developed gastric retention 3 weeks after operation, and gastroscopy revealed edema within anastomotic stoma. Conservative treatment using feeding jejunal tube was performed. After 2 weeks, normal diet was gradually restored. Patients were treated with SOX regimen 3 weeks and 2 months post operation. During follow-up period, patients were in good health without long-term complications. Therefore, GC surgery using Da Vinci robot surgery system after liver transplantation is safe and feasible.