Systemic Immune-Inflammatory Index For Evaluating Robotic and Laparoscopic Proximal Gastrectomy in Upper Gastric Cancer.

Tumor resection is a commonly used treatment method in clinical practice. With the increasing refinement of tumor surgery, the application of robotic-assisted surgery in clinical procedures has expanded. However, effective indicators for evaluating surgical efficacy and postoperative prognosis remain limited. This study introduced the systemic immune-inflammatory index (SII) to evaluate perioperative inflammatory responses and postoperative recovery following robotic and conventional laparoscopic surgery. A total of 81 patients who underwent robotic-assisted gastrointestinal tumor resection and 81 patients who underwent conventional laparoscopic gastrointestinal tumor resection were included. SII was calculated using the formula: platelet count × (neutrophil count/lymphocyte count). Postoperative SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) increased after surgery, peaked on postoperative day 3, and gradually returned toward baseline by postoperative day 7. From postoperative day 3 onward, SII and NLR values in the robotic surgery group were significantly lower than those in the laparoscopic surgery group (P < 0.05), and these differences remained significant on postoperative days 5 and 7 (P < 0.05). PLR values were significantly lower in the robotic surgery group on postoperative day 3 only (P < 0.05), whereas no significant differences were observed on postoperative days 5 or 7 (P > 0.05). Patients in the robotic surgery group also demonstrated improved postoperative recovery indicators, including earlier ambulation, earlier postoperative exhaust and feeding, lower average drainage volume and shorter postoperative hospital stay. These findings suggest that SII may serve as a useful indicator for evaluating postoperative inflammatory status and perioperative recovery following minimally invasive gastric cancer surgery.