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老年与年轻患者胃癌机器人手术后短期结局的比较:一项回顾性队列研究

Comparison of Short-Term Outcomes after Robotic Surgery for Gastric Cancer in Elderly and Younger Patients: A Retrospective Cohort Study.

作者信息

Fortuna Laura, Staderini Fabio, Coratti Francesco, Cianchi Fabio

机构信息

Unit of Digestive Surgery, Careggi University Hospital, 50134 Florence, Italy.

Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy.

出版信息

Cancers (Basel). 2024 Aug 15;16(16):2849. doi: 10.3390/cancers16162849.

Abstract

Robot-assisted surgery has recently been introduced to overcome some drawbacks and technical limitations in performing laparoscopic gastrectomy. The aim of the present study was to evaluate the feasibility and safety of robotic gastrectomy in elderly patients. The study enrolled 143 patients who underwent robotic gastrectomy in a single high-volume centre. All patients were divided into two groups based on age: elderly group ≥ 75 years old (EG; n = 64) and non-elderly group < 75 years old (NEG; n = 79). Comorbidities were significantly more frequent in the EG (95.3%) than in the NEG (81%) ( = 0.011). Similarly, the percentage of ASA 3 patients was significantly higher in the EG than in the NEG (43.8% vs. 24.0%, respectively; = 0.048). Nevertheless, the incidence of Clavien-Dindo grade III and IV complications did not differ significantly between the two groups (10.9% in the EG and 6.3% in the NEG; = 0.852). Moreover, operative time, re-operation rate, mean number of harvested lymph nodes, 30-day mortality, and median hospital stay were similar within the two groups. Our study suggests that robotic gastrectomy can be performed safely for elderly patients. In particular, chronological age does not seem to affect either the clinical or oncological short-term outcomes after robotic gastrectomy.

摘要

机器人辅助手术最近被引入,以克服在进行腹腔镜胃切除术时的一些缺点和技术限制。本研究的目的是评估老年患者机器人胃切除术的可行性和安全性。该研究纳入了143例在一个高容量单一中心接受机器人胃切除术的患者。所有患者根据年龄分为两组:≥75岁的老年组(EG;n = 64)和<75岁的非老年组(NEG;n = 79)。EG组的合并症发生率(95.3%)显著高于NEG组(81%)(P = 0.011)。同样,EG组ASA 3级患者的百分比显著高于NEG组(分别为43.8%和24.0%;P = 0.048)。然而,两组之间Clavien-Dindo III级和IV级并发症的发生率没有显著差异(EG组为10.9%,NEG组为6.3%;P = 0.852)。此外,两组的手术时间、再次手术率、平均收获淋巴结数、30天死亡率和中位住院时间相似。我们的研究表明,机器人胃切除术可以安全地应用于老年患者。特别是,实际年龄似乎并不影响机器人胃切除术后的临床或肿瘤学短期结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0995/11353219/0b169dc59c92/cancers-16-02849-g001.jpg

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