de'Angelis Nicola, Genova Pietro, Amiot Aurelien, Charpy Cecile, Disabato Mara, Belgaumkar Ajay P, Chahrour Ali, Legou Francois, Azoulay Daniel, Brunetti Francesco
Departments of *Digestive, Hepatobiliary Surgery and Liver Transplantation †Gastroenterology, EC2M3 Equipe Universitaire ‡Pathology ∥Radiology, Henri Mondor University Hospital, Université Paris Est-UPEC, Créteil, France §Department of Surgery, Ashford & St Peter's Hospitals, NHS Foundation Trust, Chertsey, Surrey, UK.
Surg Laparosc Endosc Percutan Tech. 2017 Feb;27(1):65-71. doi: 10.1097/SLE.0000000000000371.
This study compared robotic (RR) and laparoscopic resection (LR) for primary gastrointestinal stromal tumors (GISTs) of the stomach >5 cm. Twelve consecutive patients who underwent RR from 2012 to 2015 were matched for tumor size and location with 24 patients who underwent LR from 2000 to 2012. The median tumor size was 7.1 cm (range, 5.5 to 11.5). GISTs were resected by wedge resection (91.7%) or distal gastrectomy. The median RR operative time was longer than that of LR (162.5 vs. 130 min, respectively; P=0.004). Only 1 LR patient required conversion. The time to flatus and hospital stay were similar between groups. Overall, 3 patients developed minor postoperative complications that were medically treated. Mortality was nil. All resections were R0. No difference was observed in the incidence of recurrence. RR was significantly more expensive (+21.6%) than LR. RR appears to be safe and feasible for GISTs>5 cm, but is associated with longer operative times and greater costs.
本研究比较了机器人手术（RR）与腹腔镜切除术（LR）治疗胃原发性胃肠道间质瘤（GIST）且肿瘤直径>5 cm的效果。2012年至2015年连续接受RR手术的12例患者，根据肿瘤大小和位置与2000年至2012年接受LR手术的24例患者进行匹配。肿瘤中位大小为7.1 cm（范围5.5至11.5 cm）。GIST通过楔形切除术（91.7%）或远端胃切除术进行切除。RR手术的中位时间长于LR（分别为162.5分钟和130分钟；P=0.004）。仅1例LR患者需要中转手术。两组患者的胃肠排气时间和住院时间相似。总体而言，3例患者出现轻微术后并发症并接受了药物治疗。无死亡病例。所有切除均为R0切除。复发率无差异。RR的费用比LR显著更高（+21.6%）。RR对于直径>5 cm的GIST似乎是安全可行的，但与更长的手术时间和更高的费用相关。
