Intraoperative performance and outcomes of robotic and laparoscopic total gastrectomy for gastric cancer: A high-volume center retrospective propensity score matching study

被引：13

作者：

Jia, Zhuoyu ^{[1
,2
]}

Cao, Shougen ^{[1
,2
]}

Meng, Cheng ^{[1
,2
]}

Liu, Xiaodong ^{[1
,2
]}

Li, Zequn ^{[1
,2
]}

Tian, Yulong ^{[1
,2
]}

Yu, Junjian ^{[1
,2
]}

Sun, Yuqi ^{[1
,2
]}

Xu, Jianfei ^{[1
,2
]}

Liu, Gan ^{[1
,2
]}

Zhang, Xingqi ^{[1
,2
]}

Yang, Hao ^{[1
,2
]}

Zhong, Hao ^{[1
,2
]}

Wang, Qingrui ^{[1
,2
]}

Zhou, Yanbing ^{[1
,2
]}

机构：

[1] Qingdao Univ, Affiliated Hosp, Dept Gastrointestinal Surg, 16 Jiangsu Rd, Qingdao, Peoples R China

[2] Shandong Prov Key Lab Gastrointestinal Tumor Basic, Qingdao, Peoples R China

来源：

CANCER MEDICINE | 2023年 / 12卷 / 09期

关键词：

gastric cancer; laparoscopic gastrectomy; long-term survival; robotic gastrectomy; EXAMINED LYMPH-NODES; SURGICAL COMPLICATIONS; ASSISTED GASTRECTOMY; LEARNING-CURVE; SURGERY; ESOPHAGOJEJUNOSTOMY; CLASSIFICATION; DISSECTION; RECOVERY; SURVIVAL;

D O I：

10.1002/cam4.5785

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Studies on robotic total gastrectomy (RTG) are currently limited. This study aimed to compare the intraoperative performance as well as short- and long-term outcomes of RTG and laparoscopic total gastrectomy (LTG).Methods: A total of 969 patients underwent robotic (n = 161) or laparoscopic (n = 636) total gastrectomy between October 2014 and October 2021. The two groups of patients were matched 1:3 using the propensity score matching (PSM) method. The intraoperative performance as well as short- and long-term outcomes of the robotic (n = 147) and the laparoscopic (n = 371) groups were compared.Results: After matching, the estimated intraoperative blood loss was lower (80.51 +/- 68.77 vs. 89.89 & PLUSMN; 66.12, p = 0.008), and the total number of lymph node dissections was higher (34.74 +/- 12.44 vs. 29.83 +/- 12.22, p < 0.001) in the RTG group compared with the LTG group. More lymph node dissections at the upper edge of the pancreas were performed in the RTG group than in the LTG (12.59 +/- 4.18 vs. 10.33 +/- 4.58, p = 0.001). Additionally, postoperative recovery indicators and laboratory data were greater in the RTG group than those in the LTG group, while postoperative complications were comparable between the two groups (19.0% vs. 18.9%, p = 0.962). For overweight or obese patients with body mass indexes (BMIs) >= 25, certain clinical outcomes of the RTG remained advantageous, and no significant differences in three-year overall survival (OS) or relapse-free survival (RFS) were observed.Conclusions: Robotic total gastrectomy demonstrated better intraoperative performance, could improve the short-term clinical outcomes of patients, and was more conducive to patient recovery. However, the long-term efficacies of the two approaches were similar. Robotic surgical systems may reduce surgical stress responses in patients, allowing them to receive postoperative chemotherapy sooner.

引用

页码：10485 / 10498

页数：14

共 53 条

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