Li Zheng-Yan, Liu Jia-Jia, Yu Pei-Wu, Zhao Yong-Liang, Shi Yan, Luo Zi-Yan, Wu Bin, Wang Jun-Jie, Qian Feng
Department of General Surgery, Center for Minimally Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, Chongqing, P. R. China.
Gastroenterol Rep (Oxf). 2021 Jul 19;9(6):583-588. doi: 10.1093/gastro/goab021. eCollection 2021 Dec.
Total gastrectomy for carcinoma in the remnant stomach (CRS) remains a technically demanding procedure. Whether robotic surgery is superior, equal, or inferior to laparoscopic surgery in patients with CRS is unclear. This study was designed to compare the efficacy and safety of robotic total gastrectomy (RTG) and laparoscopic total gastrectomy (LTG) for the treatment of CRS.
In this cohort study, we retrospectively analysed the data from patients who underwent RTG or LTG for CRS at Southwest Hospital (Chongqing, China) between May 2006 and October 2019. The surgical outcomes, post-operative complications, and survival outcomes between the two groups were compared.
Compared with LTG, RTG was associated with similar effective operation time (272.0 vs 297.9 min, =0.170), higher total costs (105,967.2 vs 81,629.5 RMB, <0.001), and less estimated blood loss (229.2 vs 288.8 mL, =0.031). No significant differences were found between the robotic and laparoscopic groups in terms of conversion rate, time to first flatus, time to first soft diet, post-operative hospital stay, post-operative complications, R0 resection rate, and number of retrieved lymph nodes (all >0.05). The 3-year disease-free survival and 3-year overall survival rates were comparable between the two groups (65.5% vs 57.5%, =0.918; 69.0% vs 60.0%, =0.850, respectively).
RTG is a safe and feasible procedure for the treatment of CRS and could serve as an optimal treatment for CRS.
残胃癌（CRS）的全胃切除术仍是一项技术要求较高的手术。在CRS患者中，机器人手术相对于腹腔镜手术是更优、相当还是更差尚不清楚。本研究旨在比较机器人全胃切除术（RTG）和腹腔镜全胃切除术（LTG）治疗CRS的疗效和安全性。
在这项队列研究中，我们回顾性分析了2006年5月至2019年10月期间在西南医院（中国重庆）接受RTG或LTG治疗CRS的患者数据。比较了两组的手术结果、术后并发症和生存结果。
与LTG相比，RTG的有效手术时间相似（272.0对297.9分钟，=0.170），总费用更高（105,967.2对81,629.5元人民币，<0.001），估计失血量更少（229.2对288.8毫升，=0.031）。机器人组和腹腔镜组在转化率、首次排气时间、首次软食时间、术后住院时间、术后并发症、R0切除率和获取淋巴结数量方面均无显著差异（均>0.05）。两组的3年无病生存率和3年总生存率相当（分别为65.5%对57.5%，=0.918；69.0%对60.0%，=0.850）。
RTG是治疗CRS的一种安全可行的手术方法，可作为CRS的最佳治疗方法。
