Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China.
Department of Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China.
Surg Endosc. 2017 Oct;31(10):4244-4251. doi: 10.1007/s00464-017-5891-4. Epub 2017 Sep 29.
Robotic gastrectomy (RG) has been a new technical alternative for gastric cancer. However, the long-term oncological outcomes of RG still should be further evaluated. In this meta-analysis, the long-term oncological outcomes of RG and laparoscopic gastrectomy (LG) are compared.
Comprehensive searches from various databases are compared in February 2017 to identify that the oncological outcomes of RG and LG are evaluated in gastric cancer patients. The pooled oncological outcomes of the overall survival (OS), disease-free survival (DFS), and the recurrence rate were performed by adopting the meta-analysis to calculate the hazard ratio (HR) or the odds ratio with 95% confidence intervals (CIs).
Five studies that concern retrospective design and prospective data collection and involve 1614 patients were included. All the five studies evaluated OS. Two studies evaluated DFS, while four studies reported the recurrence rate or recurrence cases in RG and LG groups with the long-term follow-up. The pooled analysis showed no significant difference in OS and DFS between RG and LG, without significant between-study heterogeneity. Besides, the recurrence rate between RG and LG had no significant difference without heterogeneity.
RG could provide comparable long-term oncological outcomes as well as LG for the treatment of gastric cancer. OS, DFS, and the recurrence rate by the long-time follow-up of RG were comparable with LG. Generally speaking, more randomized clinical trials and a larger patient cohort with longer follow-up are still essential to further demonstrate the value of the robotic surgery for gastric cancer.
机器人胃切除术（RG）是胃癌的一种新的技术选择。然而，RG 的长期肿瘤学结果仍需进一步评估。在这项荟萃分析中，比较了 RG 和腹腔镜胃切除术（LG）的长期肿瘤学结果。
综合检索了 2017 年 2 月之前的各种数据库，以确定 RG 和 LG 在胃癌患者中的肿瘤学结果得到了评估。通过荟萃分析计算风险比（HR）或优势比及其 95%置信区间（CI），比较了整体生存率（OS）、无病生存率（DFS）和复发率的汇总肿瘤学结果。
纳入了 5 项回顾性设计和前瞻性数据收集的研究，共涉及 1614 例患者。所有 5 项研究均评估了 OS。2 项研究评估了 DFS，而 4 项研究报告了 RG 和 LG 组在长期随访中的复发率或复发病例。荟萃分析显示，RG 和 LG 之间在 OS 和 DFS 方面无显著差异，且无显著的研究间异质性。此外，RG 和 LG 之间的复发率无显著差异，且无异质性。
RG 为治疗胃癌提供了与 LG 相当的长期肿瘤学结果。通过 RG 的长期随访，OS、DFS 和复发率与 LG 相当。一般来说，仍然需要更多的随机临床试验和更大的患者队列，以更长的随访时间来进一步证明机器人手术在胃癌中的价值。
