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机器人胃切除术与腹腔镜胃切除术治疗临床Ⅰ/Ⅱ期胃癌患者的比较:倾向评分匹配分析。

Robotic Gastrectomy Compared with Laparoscopic Gastrectomy for Clinical Stage I/II Gastric Cancer Patients: A Propensity Score-Matched Analysis.

机构信息

Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.

Clinical Research Promotion Unit, Clinical Research Center, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan.

出版信息

World J Surg. 2021 May;45(5):1483-1494. doi: 10.1007/s00268-020-05939-8. Epub 2021 Jan 18.

Abstract

BACKGROUND

Robotic gastrectomy (RG) has been developed to address the drawbacks of laparoscopic gastrectomy (LG); however, whether or not RG is superior to conventional LG remains to be seen. The present study aimed to clarify the impact of RG on clinical stage I/II gastric cancer patients.

METHODS

The present study included 1208 patients with clinical stage I/II gastric cancer who had minimally invasive gastrectomy from January 2012 to March 2020 at the Shizuoka Cancer Center. The short- and long-term outcomes of RG and LG were compared after propensity score matching.

RESULTS

This study involved 835 LG and 345 RG patients. After propensity score matching, there were 342 patients each in the RG and LG groups, with an improved balance of confounding factors between the two groups. RG was associated with a significantly longer operative time and lower amylase concentration in the drainage fluid on the first postoperative day than LG. Furthermore, the incidence of intra-abdominal infectious complications in the RG was lower than that in the LG (4.4% vs. 9.4%; P = 0.015). The survival of the RG and LG groups was equivalent.

CONCLUSIONS

RG reduced the risk of intra-abdominal infectious complications in comparison with LG in the propensity score-matched analysis. Patients treated by the two approaches showed equivalent survival.

摘要

背景

机器人胃切除术(RG)的发展旨在解决腹腔镜胃切除术(LG)的缺点;然而,RG 是否优于传统 LG 仍有待观察。本研究旨在阐明 RG 对临床 I/II 期胃癌患者的影响。

方法

本研究纳入了 2012 年 1 月至 2020 年 3 月在静冈癌症中心接受微创胃切除术的 1208 例临床 I/II 期胃癌患者。在倾向评分匹配后,比较了 RG 和 LG 的短期和长期结果。

结果

本研究涉及 835 例 LG 和 345 例 RG 患者。经过倾向评分匹配后,RG 和 LG 组各有 342 例患者,两组混杂因素的平衡得到改善。与 LG 相比,RG 手术时间明显延长,术后第一天引流液中淀粉酶浓度较低。此外,RG 组腹腔内感染并发症的发生率低于 LG 组(4.4%比 9.4%;P=0.015)。RG 和 LG 组的生存情况相当。

结论

与 LG 相比,RG 可降低倾向评分匹配分析中腹腔内感染并发症的风险。两种方法治疗的患者生存情况相当。

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