Ali Muhammad, Wang Yang, Ding Jianyue, Wang Daorong
Department of Gastrointestinal Surgery Northern Jiangsu People's Hospital Yangzhou China.
General Surgery Institute of Yangzhou Yangzhou University Yangzhou China.
Health Sci Rep. 2022 Aug 16;5(5):e746. doi: 10.1002/hsr2.746. eCollection 2022 Sep.
Robotic gastrectomy is a commonly used procedure for early gastric cancer and it also overcomes the limitation of laparoscopic. However, the complications of robotic gastrectomy (RG) still need to be assessed. Our study was designed to compare postoperative complications of RG with laparoscopic gastrectomy (LG).
A meta-analysis and systemic review were prospectively collected using the PubMed, Cochrane Library, and MEDLINE database of published studies by comparing the RG and LG with gastric cancer up to December 2021. To evaluate the postoperative outcomes, odds ratios were calculated for Dichotomous data and the mean difference with 95% confidence interval (CI) was calculated for continuous data, and measured by the random-effect model.
Thirty-two retrospective studies describing 13,585 patients (4484 RG and 9101 LG) satisfied the inclusion criteria. A statistically significant result was in blood loss (MD = -17.97, 95% Cl: -25.61 to 10.32, < 0.001), Clavien-Dindo grade Ⅲ (odds ratio (OR) = 0.60, 95% CI: 0.48-0.76, < 0.01), and harvested lymph node (MD = 2.62, 95% CI: 2.14-3.11, < 0.001). There was no significant difference between robotic gastrectomy surgery (RGS) and laparoscopic gastrectomy surgery (LGS) regarding distal resection margin (DRM), proximal resection margin (PRM), conversion rate, anastomotic leakage, and overall complications.
Having significant outcomes in Clavien-Dindo grade III, and blood loss, harvested lymph nodes are more common in RGS, and they also help in increasing the quality of life.
机器人胃癌切除术是早期胃癌常用的手术方式,且克服了腹腔镜手术的局限性。然而,机器人胃癌切除术(RG)的并发症仍需评估。本研究旨在比较RG与腹腔镜胃癌切除术(LG)的术后并发症。
通过比较截至2021年12月发表的关于RG和LG治疗胃癌的研究,前瞻性地收集来自PubMed、Cochrane图书馆和MEDLINE数据库的荟萃分析和系统评价。为评估术后结果,对二分数据计算比值比,对连续数据计算95%置信区间(CI)的平均差,并采用随机效应模型进行测量。
32项回顾性研究描述了13585例患者(4484例行RG,9101例行LG)符合纳入标准。在失血(MD = -17.97,95%CI:-25.61至-10.32,P < 0.001)、Clavien-DindoⅢ级(比值比(OR) = 0.60,95%CI:0.48 - 0.76,P < 0.01)和获取的淋巴结数量(MD = 2.62,95%CI:2.14 - 3.11,P < 0.001)方面存在统计学显著差异。机器人胃癌切除术(RGS)与腹腔镜胃癌切除术(LGS)在远端切缘(DRM)、近端切缘(PRM)、中转率、吻合口漏及总体并发症方面无显著差异。
在Clavien-DindoⅢ级、失血及获取的淋巴结数量方面有显著结果,RGS更为常见,且有助于提高生活质量。