Department of Gastrointestinal Surgery, People's Hospital of Leshan, Sichuan Leshan, 614000, China.
Department of Gastrointestinal Surgery, People's Hospital of Leshan, Sichuan Leshan, 614000, China.
Asian J Surg. 2022 Feb;45(2):698-706. doi: 10.1016/j.asjsur.2021.07.069. Epub 2021 Aug 6.
Robotic gastrectomy (RG) shows potential as an alternative to open gastrectomy (OG), the gold standard in the surgical management of gastric cancer (GC). This meta-analysis was conducted to compare the short-term efficacy and safety of RG versus OG for GC.A systematic literature search was conducted on RG with OG for GC in randomized and semi-randomized controlled trials and observational studies. Published materials and conference papers in English and trace references included in the literature were manually searched. The retrieval period was set to end in February 2021. The quality of the included studies was evaluated, and meta-analysis was conducted using the software STATA 15.1. Eleven studies with 6693 patients were included. Major blood loss (weighted mean differences (WMD) = -114.63, 95 % CI, -182.37-46.88, P = 0.001), hospital stay (WMD = -2.21, 95 % CI, -4.32-0.09, P = 0.041), and postoperative complications (odds ratio (OR) = OR = 0.57, 95 % CI, 0.35-0.93, P = 0.025) were fewer in the RS group, and R0 resection (odds ratio (OR) = 6.26, 95 % CI, 2.733-14.35, P = 0.000) occurred more frequently in the RG group than in the OG group. But positive lymph nodes (WMD = -2.09, 95 % CI,-3.73-0.45, P = 0.012) occurred less frequently in the RG group than in the OG group, and operative time was longer in the RG group than in the OG group (WMD = 83.21, 95 % CI, 19.88-146.55, P = 0.010). RG not only provides a technique for the treatment of GC but is also safe and feasible. This finding needs to be verified by multicenter, large-sample randomized controlled trials in the future.
机器人胃切除术（RG）作为胃癌（GC）手术治疗的金标准，为开腹胃切除术（OG）提供了一种替代方案。本荟萃分析旨在比较 RG 与 OG 治疗 GC 的短期疗效和安全性。
我们在随机和半随机对照试验和观察性研究中对 RG 与 OG 治疗 GC 的文献进行了系统的文献检索。手动搜索了英语出版物和文献中包含的会议论文和追溯参考文献。检索时间截止到 2021 年 2 月。评估纳入研究的质量，并使用 STATA 15.1 软件进行荟萃分析。纳入了 11 项研究，共 6693 例患者。主要失血量（加权均数差（WMD）=-114.63，95%CI，-182.37-46.88，P=0.001）、住院时间（WMD=-2.21，95%CI，-4.32-0.09，P=0.041）和术后并发症（比值比（OR）=0.57，95%CI，0.35-0.93，P=0.025）明显低于 RG 组，而 RG 组 R0 切除（OR=6.26，95%CI，2.733-14.35，P=0.000）的发生率明显高于 OG 组。但 RG 组阳性淋巴结（WMD=-2.09，95%CI，-3.73-0.45，P=0.012）的检出率明显低于 OG 组，而 RG 组手术时间明显长于 OG 组（WMD=83.21，95%CI，19.88-146.55，P=0.010）。
RG 不仅为 GC 的治疗提供了一种技术，而且是安全可行的。这一发现需要未来通过多中心、大样本的随机对照试验来验证。
