Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
Surg Endosc. 2022 Jul;36(7):5257-5266. doi: 10.1007/s00464-021-08903-2. Epub 2022 Jan 8.
The robotic approach is especially promising for challenging surgeries, such as total gastrectomy. However, it remains unclear whether robotic total gastrectomy (RTG) is superior to conventional laparoscopic total gastrectomy (LTG). The present study aimed to clarify the impact of RTG on short- and long-term outcomes for patients with clinical stage I/IIA gastric cancer.
This study included 98 patients with clinical stage I/IIA gastric cancer who underwent minimally invasive total gastrectomy from October 2013 to December 2020 at the Shizuoka Cancer Center. The short- and long-term outcomes of RTG were compared with those of LTG.
This study included 36 RTG and 58 LTG patients. RTG was associated with a significantly longer operative time than LTG (p = 0.023). All complications tended to be lower in the RTG group than in the LTG group (2.8% and 15.5%, respectively; p = 0.083). There were no patients with anastomotic leakage in the RTG group. The multivariate analysis identified LTG as the only independent risk factor for postoperative complications (odds ratio, 6.620; 95% confidence interval, 1.132-126.4; p = 0.034). The survival of the RTG and LTG groups was equivalent.
RTG reduced the risk of complications compared to LTG. Patients treated using the two approaches showed equivalent survival.
机器人手术尤其适用于全胃切除术等具有挑战性的手术。然而，机器人全胃切除术（RTG）是否优于传统腹腔镜全胃切除术（LTG）仍不清楚。本研究旨在阐明 RTG 对临床分期 I/IIA 胃癌患者短期和长期结局的影响。
本研究纳入了 2013 年 10 月至 2020 年 12 月在静冈癌症中心接受微创全胃切除术的 98 例临床分期 I/IIA 胃癌患者。比较了 RTG 和 LTG 的短期和长期结局。
本研究纳入了 36 例 RTG 和 58 例 LTG 患者。RTG 的手术时间明显长于 LTG（p=0.023）。RTG 组的所有并发症发生率均低于 LTG 组（分别为 2.8%和 15.5%；p=0.083）。RTG 组无吻合口漏患者。多因素分析发现，LTG 是术后并发症的唯一独立危险因素（比值比，6.620；95%置信区间，1.132-126.4；p=0.034）。RTG 和 LTG 组的生存情况相当。
与 LTG 相比，RTG 降低了并发症的风险。两种方法治疗的患者生存情况相当。
