Komatsu Masaru, Kinoshita Takahiro, Akimoto Eigo, Yoshida Mitsumasa, Nagata Hiromi, Habu Takumi, Okayama Takafumi, Yura Masahiro
Gastric Surgery Division, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Surg Today. 2023 Nov;53(11):1260-1268. doi: 10.1007/s00595-023-02681-1. Epub 2023 Apr 6.
A high body mass index (BMI) generally increases the risk of postoperative complications because of the intraperitoneal adipose tissue. Robotic gastrectomy (RG) decreases the surgical difficulty of conventional laparoscopic gastrectomy (LG) for these patients. We conducted the present study to identify the advantages of RG over LG for overweight patients.
We reviewed clinical data on patients who underwent either LG or RG at the National Cancer Center Hospital East between January, 2014 and May, 2022.
The 1298 patients eligible patients were divided into a non-overweight cohort (n = 996) (LG, n = 818; RG, n = 178) and an overweight cohort (n = 302) (LG, n = 250; RG, n = 52) according to a BMI cut-off of 25 kg/m. In the overweight cohort, the RG group had a lower incidence of grade ≥ III postoperative complications (0.0 vs. 8.8%, p = 0.01) and grade ≥ II postoperative complications (11.5 vs. 22.0%, p = 0.12) than the LG group. Multivariate analysis identified that RG was significantly associated with a lower incidence of grade ≥ II postoperative complications in the overweight cohort (odds ratio, 0.33; 95% confidence interval, 0.12-0.87; p = 0.02).
RG may reduce the risk of postoperative complications, compared with conventional LG, in overweight patients.
由于腹腔内脂肪组织的存在，高体重指数（BMI）通常会增加术后并发症的风险。对于这些患者，机器人辅助胃癌切除术（RG）降低了传统腹腔镜胃癌切除术（LG）的手术难度。我们进行本研究以确定RG相对于LG在超重患者中的优势。
我们回顾了2014年1月至2022年5月期间在国立癌症中心东医院接受LG或RG治疗的患者的临床资料。
根据BMI临界值25kg/m²，1298例符合条件的患者被分为非超重队列（n = 996）（LG，n = 818；RG，n = 178）和超重队列（n = 302）（LG，n = 250；RG，n = 52）。在超重队列中，RG组术后≥III级并发症的发生率（0.0%对8.8%，p = 0.01）和≥II级并发症的发生率（11.5%对22.0%，p = 0.12）低于LG组。多因素分析表明，在超重队列中，RG与较低的≥II级术后并发症发生率显著相关（比值比，0.33；95%置信区间，0.12 - 0.87；p = 0.02）。
与传统LG相比，RG可能降低超重患者术后并发症的风险。
