Department of Surgery, University of Tokushima Graduate School, Kuramoto-cho, Tokushima, Japan.
Ann Surg Oncol. 2022 Jun;29(6):3887-3895. doi: 10.1245/s10434-021-11203-7. Epub 2022 Jan 10.
Robotic gastrectomy (RG) has been rapidly adopted for gastric cancer (GC) treatment. However, the benefits of RG over laparoscopic gastrectomy (LG) for GC remain unclear.
A total of 451 patients who underwent either RG (n = 83) or LG (n = 368) for GC were enrolled in this study. A 1:1 matched, propensity score-matched analysis was performed using the following factors: age, sex, body mass index, pT, pN, pStage, tumor location, vessel invasion, tumor markers, surgical procedure, reconstruction method, extent of lymphadenectomy, and Endoscopic Surgical Skill Qualification System qualified surgeon as an operator. The surgical outcomes of the two groups were compared.
A well-balanced cohort of 158 patients was analyzed (n = 79 in the RG group, n = 79 in the LG group). Regarding the short-term outcomes, the respective blood loss volume, drain amylase content, and number of retrieved lymph nodes in the RG and LG groups were 38.62 ± 73.06 ml and 67.53 ± 108.20 ml (p < 0.05), 450 ± 371 IU/l and 1590 ± 6392 IU/l (p < 0.01), and 35.02 ± 15.51 and 25.28 ± 11.70 (p < 0.01). The morbidity rate was similar between the RG and LG groups (not significant [NS]). Regarding the long-term survival outcomes, there were no intergroup differences in 3-year overall survival (91.72% in the RG group vs. 83.39% in the LG group: NS) and 3-year, disease-free survival (93.31% in the vs. 90.44%: NS).
RG was safe and contributed to better short-term outcomes and similar long-term survival outcomes compared with LG.
机器人胃切除术（RG）已被迅速应用于胃癌（GC）的治疗。然而，RG 相对于腹腔镜胃切除术（LG）治疗 GC 的优势仍不清楚。
共纳入 451 例接受 RG（n=83）或 LG（n=368）治疗的 GC 患者。使用以下因素进行 1:1 匹配、倾向评分匹配分析：年龄、性别、体重指数、pT、pN、p 期、肿瘤部位、血管侵犯、肿瘤标志物、手术方式、重建方法、淋巴结清扫范围和内镜外科技能资格系统合格的外科医生作为手术者。比较两组患者的手术结果。
分析了一组均衡的 158 例患者（n=79 例 RG 组，n=79 例 LG 组）。短期结果方面，RG 组和 LG 组的出血量、引流淀粉酶含量和淋巴结检出数分别为 38.62±73.06ml 和 67.53±108.20ml（p<0.05）、450±371IU/l 和 1590±6392IU/l（p<0.01）、35.02±15.51 和 25.28±11.70（p<0.01）。RG 组和 LG 组的发病率相似（无统计学意义[NS]）。长期生存结果方面，两组患者 3 年总生存率（RG 组 91.72% vs. LG 组 83.39%：NS）和 3 年无病生存率（RG 组 93.31% vs. LG 组 90.44%：NS）无差异。
与 LG 相比，RG 安全且有助于获得更好的短期结果和相似的长期生存结果。
