title: MINIMALLY INVASIVE SURGERY FOR GASTRIC CANCER: TIME TO CHANGE THE PARADIGM.
abstract: Minimally invasive surgery widely used to treat benign disorders of the digestive system, has become the focus of intense study in recent years in the field of surgical oncology. Since then, the experience with this kind of approach has grown, aiming to provide the same oncological outcomes and survival to conventional surgery. Regarding gastric cancer, surgery is still considered the only curative treatment, considering the extent of resection and lymphadenectomy performed. Conventional surgery remains the main modality performed worldwide. Notwithstanding, the role of the minimally invasive access is yet to be clarified.
  
  
  
  To evaluate and summarize the current status of minimally invasive resection of gastric cancer.
  
  
  
  A literature review was performed using Medline/PubMed, Cochrane Library and SciELO with the following headings: gastric cancer, minimally invasive surgery, robotic gastrectomy, laparoscopic gastrectomy, stomach cancer. The language used for the research was English.
  
  
  
  28 articles were considered, including randomized controlled trials, meta-analyzes, prospective and retrospective cohort studies.
  
  
  
  Minimally invasive gastrectomy may be considered as a technical option in the treatment of early gastric cancer. As for advanced cancer, recent studies have demonstrated the safety and feasibility of the laparoscopic approach. Robotic gastrectomy will probably improve outcomes obtained with laparoscopy. However, high cost is still a barrier to its use on a large scale.
authors.affiliation: Central Institute of Hospital de Clínicas.
authors.forename: Leandro Cardoso
authors.initials: LC
authors.lastname: Barchi
authors.affiliation: Central Institute of Hospital de Clínicas.
authors.forename: Carlos Eduardos
authors.initials: CE
authors.lastname: Jacob
authors.affiliation: Central Institute of Hospital de Clínicas.
authors.forename: Cláudio José Caldas
authors.initials: CJ
authors.lastname: Bresciani
authors.affiliation: Cancer Institute of the State of São Paulo, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Osmar Kenji
authors.initials: OK
authors.lastname: Yagi
authors.affiliation: Central Institute of Hospital de Clínicas.
authors.forename: Donato Roberto
authors.initials: DR
authors.lastname: Mucerino
authors.affiliation: Central Institute of Hospital de Clínicas.
authors.forename: Fábio Pinatel
authors.initials: FP
authors.lastname: Lopasso
authors.affiliation: Central Institute of Hospital de Clínicas.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Mester
authors.affiliation: Cancer Institute of the State of São Paulo, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Ulysses
authors.initials: U
authors.lastname: Ribeiro-Júnior
authors.affiliation: Cancer Institute of the State of São Paulo, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: André Roncon
authors.initials: AR
authors.lastname: Dias
authors.affiliation: Cancer Institute of the State of São Paulo, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Marcus Fernando Kodama Pertille
authors.initials: MF
authors.lastname: Ramos
authors.affiliation: Cancer Institute of the State of São Paulo, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
authors.affiliation: Cancer Institute of the State of São Paulo, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Zilberstein
mesh_terms: D005743:Gastrectomy / Q000379:methods* / Q000592:standards; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009367:Neoplasm Staging; D065287:Robotic Surgical Procedures; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*