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机器人手术与腹腔镜手术治疗胃癌患者的远端胃切除术:一项倾向评分匹配分析

Robotic versus laparoscopic distal gastrectomy in patients with gastric cancer: a propensity score-matched analysis.

作者信息

Isobe Taro, Murakami Naotaka, Minami Taizan, Tanaka Yuya, Kaku Hideaki, Umetani Yuki, Kizaki Junya, Aoyagi Keishiro, Fujita Fumihiko, Akagi Yoshito

机构信息

Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.

出版信息

BMC Surg. 2021 Apr 21;21(1):203. doi: 10.1186/s12893-021-01212-4.

Abstract

BACKGROUND

Robotic distal gastrectomy (RDG) has been increasingly used for the treatment of gastric cancer (GC). However, whether RDG has a clinical advantage over laparoscopic distal gastrectomy (LDG) is yet to be determined. Thus, this study aimed to assess the feasibility and safety of RDG for the treatment of GC as compared with LDG.

METHODS

In total, 157 patients were enrolled between February 2018 and August 2020 in this retrospective study. We then compared the surgical outcomes between RDG and LDG using propensity score-matching (PSM) analysis to reduce the confounding differences.

RESULTS

After PSM, a clinicopathologically well-balanced cohort of 100 patients (50 in each group) was analyzed. The operation time for the RDG group (350.1 ± 58.1 min) was determined to be significantly longer than that for the LDG group (257.5 ± 63.7 min; P < 0.0001). Of interest, there was a decreased incidence of pancreatic fistulas and severe complications after RDG as compared with LDG (P = 0.092 and P = 0.061, respectively). In addition, postoperative hospital stay was statistically slightly shorter in the RDG group as compared with the LDG group (12.0 ± 5.6 vs. 13.0 ± 12.3 days; P = 0.038).

CONCLUSIONS

Our study confirmed that RDG is a feasible and safe procedure for GC in terms of short-term surgical outcomes. A surgical robot might reduce postoperative severe complications and length of hospital stay.

摘要

背景

机器人远端胃癌切除术(RDG)已越来越多地用于治疗胃癌(GC)。然而,RDG是否比腹腔镜远端胃癌切除术(LDG)具有临床优势尚待确定。因此,本研究旨在评估与LDG相比,RDG治疗GC的可行性和安全性。

方法

在这项回顾性研究中,2018年2月至2020年8月共纳入157例患者。然后,我们使用倾向评分匹配(PSM)分析比较了RDG和LDG之间的手术结果,以减少混杂差异。

结果

PSM后,分析了100例患者(每组50例)的临床病理平衡队列。RDG组的手术时间(350.1±58.1分钟)明显长于LDG组(257.5±63.7分钟;P<0.0001)。有趣的是,与LDG相比,RDG后胰瘘和严重并发症的发生率有所降低(分别为P=0.092和P=0.061)。此外,RDG组的术后住院时间在统计学上比LDG组略短(12.0±5.6天对13.0±12.3天;P=0.038)。

结论

我们的研究证实,就短期手术结果而言,RDG是一种治疗GC的可行且安全的手术方法。手术机器人可能会减少术后严重并发症和住院时间。

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