Yaman Sibel, Teke Zafer, Yüksel Sercan, Topal Ugur, Karatay Hüseyin, Gökduman Hürü Ceren, Karaköse Erdal, Bektaş Hasan
Department of General Surgery, Başakşehir Çam and Sakura City Hospital, University of Health Sciences, Istanbul, Turkey.
Department of Pathology, Başakşehir Çam and Sakura City Hospital, University of Health Sciences, Istanbul, Turkey.
J Minim Access Surg. 2025 Jul 1;21(3):256-264. doi: 10.4103/jmas.jmas_254_24. Epub 2025 Jul 14.
Surgical resection remains the cornerstone treatment for gastric cancer, which ranks as the fifth most common cancer globally. Although minimally invasive surgical techniques are gaining popularity, their safety and oncological adequacy remain subjects of ongoing debate. This study aims to contribute to the medical literature by comparing open, laparoscopic and robotic gastrectomy techniques in the treatment of gastric cancer, focusing on short-term oncological outcomes.
Patients aged 18 years and older who underwent surgery for gastric adenocarcinoma at our institution between April 2020 and September 2022 were included in the study. The patients were categorised into three groups based on the surgical approach: open gastrectomy, laparoscopic gastrectomy and robotic gastrectomy. Demographic data, intraoperative and post-operative findings, tumour characteristics and short-term morbidity and mortality outcomes were analysed retrospectively.
A total of 109 patients (37 females [33.9%] and 72 males [66.1%]) with a mean age of 63.1 ± 11.4 years were included. The operative time was significantly shorter in the open gastrectomy group compared to the laparoscopic and robotic groups (P = 0.012). The initiation of oral intake and post-operative hospital stay were significantly shorter in the robotic gastrectomy group (P < 0.001). At 1-year follow-up, disease-free survival rates were higher, and mortality rates were lower in the robotic gastrectomy group compared to the other groups (P = 0.030). Furthermore, the completion rate of adjuvant therapy was significantly higher in the robotic group than in the other groups (P = 0.008).
In conclusion, minimally invasive surgical techniques, particularly robotic gastrectomy, provide a safe and oncologically adequate alternative to open surgery for the treatment of gastric cancer. These methods can be safely employed in selected patients by experienced teams at high-volume centres.
手术切除仍然是胃癌的基石性治疗方法，胃癌是全球第五大常见癌症。尽管微创外科技术越来越受欢迎，但其安全性和肿瘤学充分性仍是持续争论的话题。本研究旨在通过比较开放、腹腔镜和机器人胃癌切除术治疗胃癌的技术，关注短期肿瘤学结果，为医学文献做出贡献。
纳入2020年4月至2022年9月在我院接受胃腺癌手术的18岁及以上患者。根据手术方式将患者分为三组：开放胃切除术、腹腔镜胃切除术和机器人胃切除术。回顾性分析人口统计学数据、术中及术后发现、肿瘤特征以及短期发病率和死亡率结果。
共纳入109例患者（37例女性[33.9%]和72例男性[66.1%]），平均年龄63.1±11.4岁。与腹腔镜组和机器人组相比，开放胃切除术组的手术时间明显更短（P = 0.012）。机器人胃切除术组的经口进食开始时间和术后住院时间明显更短（P < 0.001）。在1年随访时，与其他组相比，机器人胃切除术组的无病生存率更高，死亡率更低（P = 0.030）。此外，机器人组辅助治疗的完成率明显高于其他组（P = 0.008）。
总之，微创外科技术，尤其是机器人胃切除术，为胃癌治疗提供了一种安全且肿瘤学上足够的开放手术替代方案。经验丰富的团队在大容量中心可以安全地将这些方法应用于选定的患者。
