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机器人胃癌切除术的短期和长期结果:一项单中心、单臂前瞻性研究

Short-Term and Long-Term Outcomes of Robotic Gastrectomy for Gastric Cancer: A Single-Center, Single-Arm Prospective Study.

作者信息

Kanaya Nobuhiko, Kuroda Shinji, Kakiutchi Yoshihiko, Kashima Hajime, Kikuchi Satoru, Nishizaki Masahiko, Kagawa Shunsuke, Fujiwara Toshiyoshi

机构信息

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, JPN.

Department of Surgery, Tsuyama Chuo Hospital, Tsuyama, JPN.

出版信息

Cureus. 2025 Feb 15;17(2):e79063. doi: 10.7759/cureus.79063. eCollection 2025 Feb.

Abstract

BACKGROUND

Robotic gastrectomy (RG) has emerged as a promising approach for gastric cancer (GC) treatment, offering advantages such as enhanced dexterity, improved visualization, and increased precision. However, its widespread adoption remains limited due to technical complexity, high costs, limited applications, and insufficient evidence.

METHODS

We conducted a single-center, prospective study to evaluate the safety and feasibility of RG, including robotic total gastrectomy (RTG), robotic proximal gastrectomy (RPG), and robotic distal gastrectomy (RDG) with D1+ or D2 lymphadenectomy, in clinical stage I/II GC. The primary endpoint was the incidence of intraoperative and postoperative complications, while the secondary endpoints included surgical outcomes and long-term prognosis.

RESULTS

Seven patients were enrolled. No intraoperative complications or conversions to open surgery occurred. The primary endpoint was met, with no major postoperative complications. RTG had a longer operative time and more lymph nodes dissected than RDG and RPG. The median postoperative hospital stay was 10 days. Recurrence was observed in two cases, one of which achieved long-term survival without chemotherapy.

CONCLUSION

Our findings demonstrate the safety and feasibility of RG for early and advanced GC. Further multicenter studies with larger cohorts are needed to establish its oncological benefits and cost-effectiveness, facilitating broader clinical adoption.

摘要

背景

机器人胃癌切除术(RG)已成为一种有前景的胃癌(GC)治疗方法,具有诸如灵活性增强、视野改善和精度提高等优势。然而,由于技术复杂性、高成本、应用受限以及证据不足,其广泛应用仍然有限。

方法

我们开展了一项单中心前瞻性研究,以评估RG(包括机器人全胃切除术(RTG)、机器人近端胃切除术(RPG)以及行D1 + 或D2淋巴结清扫的机器人远端胃切除术(RDG))在临床I/II期GC中的安全性和可行性。主要终点是术中和术后并发症的发生率,次要终点包括手术结果和长期预后。

结果

纳入了7例患者。未发生术中并发症或转为开放手术的情况。达到了主要终点,无重大术后并发症。RTG的手术时间比RDG和RPG长,清扫的淋巴结更多。术后中位住院时间为10天。观察到2例复发,其中1例在未进行化疗的情况下实现了长期生存。

结论

我们的研究结果证明了RG用于早期和进展期GC的安全性和可行性。需要进一步开展更大样本量的多中心研究,以确定其肿瘤学益处和成本效益,促进其更广泛的临床应用。

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