Baral Shantanu, Arawker Mubeen Hussein, Sun Qiannan, Jiang Mingrui, Wang Liuhua, Wang Yong, Ali Muhammad, Wang Daorong
Clinical Medical College, Yangzhou University, Yangzhou China.
Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital, Yangzhou China.
Front Surg. 2022 Jun 28;9:895976. doi: 10.3389/fsurg.2022.895976. eCollection 2022.
Laparoscopic gastrectomy and robotic gastrectomy are the most widely adopted treatment of choice for gastric cancer. To systematically assess the safety and effectiveness of robotic gastrectomy for gastric cancer, we carried out a systematic review and meta-analysis on short-term and long-term outcomes of robotic gastrectomy.
In order to find relevant studies on the efficacy and safety of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) in the treatment of gastric cancer, numerous medical databases including PubMed, Medline, Cochrane Library, Embase, Google Scholar, and China Journal Full-text Database (CNKI) were consulted, and Chinese and English studies on the efficacy and safety of RG and LG in the treatment of gastric cancer published from 2012 to 2022 were screened according to inclusion and exclusion criteria, and a meta-analysis was conducted using RevMan 5.4 software.
The meta-analysis inlcuded 48 literatures, with 20,151 gastric cancer patients, including 6,175 in the RG group and 13,976 in the LG group, respectively. Results of our meta-analysis showed that RG group had prololonged operative time (= 35.72, 95% = 28.59-42.86, < 0.05) (RG: mean ± SD = 258.69 min ± 32.98; LG: mean ± SD = 221.85 min ± 31.18), reduced blood loss ( = -21.93, 95% = -28.94 to -14.91, < 0.05) (RG: mean ± SD = 105.22 ml ± 62.79; LG: mean ± SD = 127.34 ml ± 79.62), higher number of harvested lymph nodes (= 2.81, 95% = 1.99-3.63, < 0.05) (RG: mean ± SD = 35.88 ± 4.14; LG: mean ± SD = 32.73 ± 4.67), time to first postoperative food intake shortened ( = -0.20, 95% = -0.29 to -0.10, < 0.05) (RG: mean ± SD = 4.5 d ± 1.94; LG: mean ± SD = 4.7 d ± 1.54), and lower length of postoperative hospital stay ( = -0.54, 95% = -0.83 to -0.24, < 0.05) (RG: mean ± SD = 8.91 d ± 6.13; LG: mean ± SD = 9.61 d ± 7.74) in comparison to the LG group. While the other variables, for example, time to first postoperative flatus, postoperative complications, proximal and distal mar gin, resection rate, mortality rate, conversion rate, and 3-year overall survival rate were all found to be statistically similar at > 0.05.
In the treatment of gastric cancer, robotic gastrectomy is a safe and effective procedure that has both short- and long-term effects. To properly evaluate the advantages of robotic surgery in gastric cancer, more randomised controlled studies with rigorous research methodologies are needed.
腹腔镜胃切除术和机器人辅助胃切除术是目前应用最广泛的胃癌治疗选择。为系统评估机器人辅助胃切除术治疗胃癌的安全性和有效性，我们对机器人辅助胃切除术的短期和长期疗效进行了系统评价和荟萃分析。
为查找有关机器人辅助胃切除术（RG）和腹腔镜胃切除术（LG）治疗胃癌疗效和安全性的相关研究，我们查阅了多个医学数据库，包括PubMed、Medline、Cochrane图书馆、Embase、谷歌学术以及中国期刊全文数据库（CNKI），并根据纳入和排除标准筛选了2012年至2022年发表的关于RG和LG治疗胃癌疗效和安全性的中英文研究，使用RevMan 5.4软件进行荟萃分析。
荟萃分析纳入48篇文献，共20151例胃癌患者，其中RG组6175例，LG组13976例。荟萃分析结果显示，与LG组相比，RG组手术时间延长（=35.72，95% =28.59 - 42.86，<0.05）（RG：均值±标准差=258.69分钟±32.98；LG：均值±标准差=221.85分钟±31.18），术中失血减少（=-21.93，95% =-28.94至-14.91，<0.05）（RG：均值±标准差=105.22毫升±62.
