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使用达芬奇™ SP系统进行机器人远端胃癌切除术的初步临床经验:一项单中心回顾性研究。

Initial clinical experiences of robotic distal gastrectomy for gastric cancer using the Da Vinci™ SP system: a single-center retrospective study.

作者信息

Ito Ayaka, Nakauchi Masaya, Fujita Masahiro, Umeki Yusuke, Suzuki Kazumitsu, Serizawa Akiko, Akimoto Shingo, Watanabe Yusuke, Tanaka Tsuyoshi, Shibasaki Susumu, Inaba Kazuki, Uyama Ichiro, Suda Koichi

机构信息

Department of Surgery, Fujita Health University, Toyoake, Japan.

Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.

出版信息

Langenbecks Arch Surg. 2025 Mar 29;410(1):110. doi: 10.1007/s00423-025-03685-w.

Abstract

PURPOSE

Reduced-port surgery has been utilized in gastric cancer surgery but is not predominantly used due to its high technical difficulty. A new single-port surgical robot named da Vinci™ SP System (DVSP) was launched and eventually approved for clinical use in Japan in November 2022. We initiated robotic gastrectomy for gastric cancer using DVSP in March 2023. Here, we report our initial experiences and assessments of the feasibility and safety of robotic gastrectomy for gastric cancer using DVSP.

METHODS

This single-center retrospective study included 20 patients with gastric cancer who underwent robotic gastrectomy with DVSP from March 2023 to April 2024. The primary endpoint was the postoperative complication rate within 30 days postoperatively. Secondary endpoints were surgical outcomes, including intraoperative adverse events, operative time, blood loss, and the number of dissected nodes.

RESULTS

Of the 20 patients, 6 (30.0%) were male. The median age was 74 years. Tumors in the middle to lower stomach were observed in 20 patients (100.0%), including 18 (90.0%) and 2 (10.0%) with clinical stages I and II diseases, respectively. All patients underwent distal gastrectomy. The postoperative complications of Clavien-Dindo grade ≥ II occurred in 3 (15%) patients. Intraoperative adverse events, including conversion to other approaches, were not observed. All patients underwent R0 resection. The median operative and console times were 289 and 240 min, respectively. The median blood loss was 11 mL with 50 dissected nodes.

CONCLUSION

This study revealed the safe performance of robotic distal gastrectomy with standard lymphadenectomy for clinical stage I/II gastric cancer using DVSP.

摘要

目的

减少切口手术已应用于胃癌手术,但由于技术难度高,尚未得到广泛应用。一种名为达芬奇™ SP系统(DVSP)的新型单孔手术机器人于2022年11月推出,并最终在日本获批用于临床。我们于2023年3月开始使用DVSP进行胃癌机器人切除术。在此,我们报告使用DVSP进行胃癌机器人切除术的初步经验以及对其可行性和安全性的评估。

方法

这项单中心回顾性研究纳入了20例在2023年3月至2024年4月期间接受DVSP胃癌机器人切除术的患者。主要终点是术后30天内的术后并发症发生率。次要终点是手术结果,包括术中不良事件、手术时间、失血量和清扫淋巴结数量。

结果

20例患者中,6例(30.0%)为男性。中位年龄为74岁。20例患者(100.0%)均观察到胃中下部肿瘤,其中临床I期和II期疾病分别为18例(90.0%)和2例(10.0%)。所有患者均接受了远端胃切除术。3例(15%)患者发生了Clavien-Dindo分级≥II级的术后并发症。未观察到术中不良事件,包括转为其他手术方式。所有患者均实现R0切除。中位手术时间和控制台操作时间分别为289分钟和240分钟。中位失血量为11毫升,清扫淋巴结50枚。

结论

本研究显示了使用DVSP对临床I/II期胃癌进行机器人远端胃切除术并标准淋巴结清扫的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c760/11954707/a1f00c2ee8c9/423_2025_3685_Fig1_HTML.jpg

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