Department of Surgery, Minimally Invasive and Robot Center, Dong-A University College of Medicine, 3-1 Dongdaeshin-Dong, Seo-Gu, Busan 602-715, Korea.
Surg Endosc. 2010 Mar;24(3):610-5. doi: 10.1007/s00464-009-0618-9. Epub 2009 Aug 18.
Robotic gastrectomy in the setting of gastric cancer is reported by some investigators. However, no study has compared robotic surgery with open or laparoscopic surgery for patients with gastric cancer. This study aimed to determine the clinical benefits of robotic gastrectomy over open and laparoscopic gastrectomy for the treatment of gastric cancer.
After the introduction of the da Vinci surgical system in November 2007 at the authors' hospital, 18 robotic gastrectomies were performed from 31 December 2007 to 30 June 2008. The prospective data from gastric cancer patients who underwent gastrectomies (16 robotic, 11 laparoscopic, and 12 open) during the same period were retrospectively analyzed.
Sex, age, comorbidity, extent of lymphadenectomy, pT stage, lymph node metastasis, and number of lymph nodes retrieved were similar among the three groups. The estimated blood loss was significantly less in the robotic gastrectomy group than in the open group (p = 0.0312), and the postoperative hospital stay in the robotic group was significantly shorter than in the open and laparoscopic gastrectomy groups (p < 0.001). Postoperative morbidity and time to first flatus were similar in the three groups. There was no open or laparoscopic conversion in the robotic group. No postoperative mortality occurred in any group.
Robotic gastrectomy for the treatment of gastric cancer is a feasible and safe procedure in the hands of experienced laparoscopic surgeons. Robotic gastrectomy offers better short-term surgical outcomes than the open and laparoscopic methods. Furthermore, this procedure may be a preferable alternative for the treatment of gastric cancer.
一些研究人员已经报道了机器人胃癌根治术的应用。然而，目前尚无研究比较机器人手术与开腹或腹腔镜手术治疗胃癌的疗效。本研究旨在评估机器人胃癌根治术相对于开腹和腹腔镜手术治疗胃癌的临床优势。
作者所在医院于 2007 年 11 月引入达芬奇机器人手术系统，自 2007 年 12 月 31 日至 2008 年 6 月 30 日，完成 18 例机器人胃癌根治术。回顾性分析同期接受胃癌根治术（16 例机器人手术、11 例腹腔镜手术和 12 例开腹手术）的胃癌患者的前瞻性数据。
三组患者的性别、年龄、合并症、淋巴结清扫范围、pT 分期、淋巴结转移、淋巴结检出数量等差异均无统计学意义。机器人手术组术中出血量显著少于开腹手术组（p = 0.0312），术后住院时间显著短于开腹和腹腔镜手术组（p < 0.001）。三组患者术后并发症发生率和首次排气时间相似。机器人手术组无中转开腹或腹腔镜手术。三组患者均无术后死亡。
对于有经验的腹腔镜外科医生来说，机器人胃癌根治术是一种可行且安全的术式。与开腹和腹腔镜手术相比，机器人手术具有更好的短期手术效果。此外，对于胃癌的治疗，机器人手术可能是一种更优的选择。
