Division of Upper Gastrointestinal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul, 136-705, Korea.
Ann Surg Oncol. 2013 Apr;20(4):1258-65. doi: 10.1245/s10434-012-2679-6. Epub 2012 Oct 19.
No previous robotic studies present an equivalent surgical quality comparison in an experienced setting for gastric cancer. In addition, a reliable postoperative complication assessment is needed to accurately evaluate surgical outcomes.
After 20 cases of robotic-assisted gastrectomy (RAG), a total of 121 consecutive gastric cancer patients underwent gastrectomy (38 RAG vs 83 laparoscopic-assisted gastrectomy [LAG]) from February 2009 to November 2010 at the Department of Surgery, Korea University Anam Hospital, Seoul, Korea. The Clavien-Dindo (C-D) classification was used to classify surgical complications. The granulocyte-to-lymphocyte (G:L) ratio was analyzed to evaluate surgical stress.
The baseline characteristics, with the exception of age, were similar. The mean total operation time for RAG (234.4 ± 48.0 min) was not significantly different than that for LAG (220.0 ± 60.6 min; P = 0.198). However, in obese patients, fewer lymph nodes were harvested by RAG (23.4 ± 7.0) than by LAG (32.2 ± 12.5, P = 0.006). Overall C-D complications were more common for RAG (47.3 vs 38.5 %), but the difference was not significant (P = 0.361). The mean hospital stay was similar for the 2 groups. Surgical stress as estimated by the G:L ratio was comparable between the 2 groups.
RAG performed by an experienced surgeon resulted in similar postoperative outcomes and complications to those of LAG. Assessment of operation time, C-D complication grade, and G:L ratio revealed that RAG is a practical and feasible alternative to LAG, with the possible exception of obese patients.
以前没有机器人研究在经验丰富的环境中对胃癌进行手术质量的等效比较。此外，需要可靠的术后并发症评估来准确评估手术结果。
在韩国大学安岩医院外科进行 20 例机器人辅助胃切除术（RAG）后，2009 年 2 月至 2010 年 11 月共有 121 例连续胃癌患者接受胃切除术（38 例 RAG 与 83 例腹腔镜辅助胃切除术[LAG]）。采用 Clavien-Dindo（C-D）分类对手术并发症进行分类。分析粒细胞与淋巴细胞（G：L）比值以评估手术应激。
除年龄外，基线特征相似。RAG 的平均总手术时间（234.4±48.0 分钟）与 LAG（220.0±60.6 分钟；P=0.198）无显著差异。然而，在肥胖患者中，RAG 采集的淋巴结较少（23.4±7.0），而 LAG 采集的淋巴结较多（32.2±12.5，P=0.006）。RAG 的总体 C-D 并发症更常见（47.3%比 38.5%），但差异无统计学意义（P=0.361）。两组的平均住院时间相似。两组的 G：L 比值估计的手术应激相似。
由经验丰富的外科医生进行的 RAG 与 LAG 的术后结果和并发症相似。手术时间、C-D 并发症分级和 G：L 比值的评估表明，RAG 是 LAG 的一种实用且可行的替代方法，肥胖患者除外。
