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机器人胃癌切除术的长期临床结局:一项大型单机构回顾性研究。

The long-term clinical outcomes of robotic gastrectomy for gastric cancer: a large-scale single institutional retrospective study.

作者信息

Jiang Yuxing, Zhao Yongliang, Qian Feng, Shi Yan, Hao Yingxue, Chen Jun, Li Pingang, Yu Peiwu

机构信息

Department of General Surgery and Center of Minimal Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University Gaotanyan Street 30, Shapingba District, Chongqing 400038, China.

出版信息

Am J Transl Res. 2018 Oct 15;10(10):3233-3242. eCollection 2018.

Abstract

BACKGROUNDS AND PURPOSE

Robotic surgery has been applied in gastric carcinoma over a decade. Although a series of studies were performed to investigate the short-term outcomes of robot-assisted gastrectomy, few papers were in view of long-term outcomes. The current study was aimed to explore the oncological outcomes of robotic gastrectomy for gastric cancer patients.

METHODS

A total of 606 gastric cancer patients who underwent robot-assisted gastrectomy during March 2010 through March 2017, were enrolled in this research. The clinicopathologic characteristics, surgical procedures along with follow-up information and prognostic factors were recorded in detail. The disease-free survival and overall survival rates were tested by Kaplan-Meier analysis.

RESULTS

All the patients underwent the robotic surgery including 15 proximal gastrectomies, 403 distal gastrectomies, 169 total gastrectomies and 19 remnant gastrectomies. Fifiy-six (9.24%) patients were lost in the follow-up process (3-87 months, a media of 42 months). There were 119 recurrences observed, including 55 local recurrences, 51 peritoneal metastasis and 13 distant metastasis. The 3-year disease-free survival and overall survival were 73.60% and 74.24%, while the 5-year disease-free survivorship and overall survival rates were 68.73% and 69.33%. The 5-year overall survival rates grouped based on TNM stage were 96.58% for IA, 88.16% for IB, 87.03% for IIA, 80.62% fo IIB, 58.50% for IIIA, 48.62% for IIIB, 45.32% for IIIC and 17.03% for IV.

CONCLUSION

Robot-assisted gastrectomy is a valuable procedure for gastric cancer patients. Beside its feasibility and safety, it reveals an acceptable long-term clinical outcome.

摘要

背景与目的

机器人手术已应用于胃癌治疗十余年。尽管已有一系列研究探讨机器人辅助胃切除术的短期疗效,但着眼于长期疗效的论文较少。本研究旨在探讨机器人胃癌切除术对胃癌患者的肿瘤学疗效。

方法

本研究纳入了2010年3月至2017年3月期间接受机器人辅助胃切除术的606例胃癌患者。详细记录患者的临床病理特征、手术方式以及随访信息和预后因素。采用Kaplan-Meier分析检验无病生存率和总生存率。

结果

所有患者均接受了机器人手术,包括15例近端胃切除术、403例远端胃切除术、169例全胃切除术和19例残胃切除术。56例(9.24%)患者在随访过程中失访(3 - 87个月,平均42个月)。观察到119例复发,包括55例局部复发、51例腹膜转移和13例远处转移。3年无病生存率和总生存率分别为73.60%和74.24%,5年无病生存率和总生存率分别为68.73%和69.33%。根据TNM分期分组的5年总生存率,IA期为96.58%,IB期为88.16%,IIA期为87.03%,IIB期为80.62%,IIIA期为58.50%,IIIB期为48.62%,IIIC期为45.32%,IV期为17.03%。

结论

机器人辅助胃切除术对胃癌患者是一种有价值的手术方式。除了其可行性和安全性外,还显示出可接受的长期临床疗效。

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