Hikage Makoto, Tokunaga Masanori, Makuuchi Rie, Irino Tomoyuki, Tanizawa Yutaka, Bando Etsuro, Kawamura Taiichi, Terashima Masanori
Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Department of Surgery, Sendai City Hospital, Miyagi, Japan.
World J Surg. 2018 Jun;42(6):1803-1810. doi: 10.1007/s00268-017-4345-4.
Increasing numbers of patients are treated by robotic distal gastrectomy (RDG); however, it remains unclear whether RDG is clinically comparable with conventional laparoscopic distal gastrectomy (LDG). This study aimed to clarify the feasibility of RDG from safety aspects.
The study included 109 cT1 gastric cancer patients who underwent RDG at Shizuoka Cancer Center from January 2012 to April 2015. Short-term outcomes were compared with 160 cT1 gastric cancer patients who underwent LDG during the same period.
Patient characteristics were well matched. The RDG patients experienced longer operative times (323 min) than LDG patients (285 min; P < 0.001), although all other surgical outcomes were comparable between the groups. Drain amylase levels on POD 1 were significantly lower in the RDG group compared to LDG cases (median 452 U/L and 892 U/L; P < 0.001). The incidence of all complications was similar across the study patients, although intra-abdominal infectious complications tended to be lower in the RDG group than in the LDG group (2.8 and 8.1%; P = 0.112).
RDG was comparable to LDG in terms of feasibility for cT1 gastric cancer. RDG has the potential to reduce pancreas damage and thus to decrease intra-abdominal infectious complications.
接受机器人远端胃癌切除术（RDG）治疗的患者数量日益增加；然而，RDG在临床上是否与传统腹腔镜远端胃癌切除术（LDG）相当仍不明确。本研究旨在从安全性方面阐明RDG的可行性。
本研究纳入了2012年1月至2015年4月在静冈癌症中心接受RDG的109例cT1期胃癌患者。将其短期结局与同期接受LDG的160例cT1期胃癌患者进行比较。
患者特征匹配良好。RDG组患者的手术时间（323分钟）比LDG组患者（285分钟；P<0.001）长，不过两组之间的所有其他手术结局具有可比性。与LDG组相比，RDG组术后第1天引流液淀粉酶水平显著更低（中位数分别为452 U/L和892 U/L；P<0.001）。所有并发症的发生率在研究患者中相似，尽管RDG组腹腔内感染性并发症的发生率往往低于LDG组（分别为2.8%和8.1%；P=0.112）。
对于cT1期胃癌，RDG在可行性方面与LDG相当。RDG有可能减少胰腺损伤，从而降低腹腔内感染性并发症的发生。
