Solo surgery in robot-assisted gastrectomy versus laparoscopic gastrectomy for gastric cancer: a propensity score-matched analysis

被引:5
作者
Miyai, Hirotaka [1 ]
Fujita, Kohei [1 ]
Saito, Masaki [2 ]
Fujii, Yoshiaki [2 ]
Saito, Tsuyoshi [1 ]
Kato, Jyunki [1 ]
Sawai, Misato [1 ]
Eguchi, Yuki [1 ]
Hirokawa, Takahisa [1 ]
Yamamoto, Minoru [1 ]
Kobayashi, Kenji [1 ]
Takiguchi, Shuji [2 ]
机构
[1] Kariya Toyota Gen Hosp, Dept Gastroenterol Surg, Kariya, Aichi 4488505, Japan
[2] Nagoya City Univ, Grad Sch Med Sci, Dept Gastroenterol Surg, Nagoya, Aichi 4678601, Japan
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2023年 / 37卷 / 07期
关键词
Minimally invasive surgery; Gastric cancer; Robotic surgery; Solo surgery; PANCREATIC FISTULA; DISTAL GASTRECTOMY; SURGICAL COMPLICATIONS; OUTCOMES; CLASSIFICATION; D2;
D O I
10.1007/s00464-023-10113-x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Robot-assisted gastrectomy (RG) for gastric cancer is still not well standardized. This study aimed to explore the feasibility and effectiveness of solo surgery in robot-assisted gastrectomy (SRG) for gastric cancer compared to laparoscopic gastrectomy (LG). Methods This was a single-center retrospective comparative study between SRG and conventional LG. Between April 2015 and December 2022, 510 patients underwent gastrectomy, and data from a prospectively collected database were analyzed. We identified 372 patients who underwent LG (n = 267) and SRG (n = 105) and the remaining 138 patients were excluded because of remnant gastric cancer, esophagogastric junction cancer, open gastrectomy, concurrent surgery for concomitant malignancies, RG before starting SRG, or cases in which the author was unable to perform or supervise gastrectomy. Propensity score matching was performed at a ratio of 1:1 to reduce bias from confounding patient-related variables, and short-term outcomes were compared between the groups. Results After propensity score matching, 90 pairs of patients who underwent LG and SRG were selected. In the propensity-matched cohort, the operation time was significantly shorter in the SRG group than that in the LG group (SRG = 305.7 +/- 74.0 min vs. LG = 340.3 +/- 91.65 min, p < 0.0058), less estimated blood loss was observed in the SRG group than that in the LG group ( SRG = 25.6 +/- 50.6 mL vs. LG = 76.1 +/- 104.2 mL, p < 0.0001) and postoperative hospital stay was shorter in the SRG group than that in the LG group (SRG = 7.1 +/- 0.8 days vs. LG = 9.1 +/- 7.7 days, p = 0.015). Conclusion We found that SRG for gastric cancer was technically feasible and effective with favorable short-term outcomes, including shorter operative time, less estimated blood loss, shorter hospital stays, and lower postoperative morbidity than those in LG. [GRAPHICS] .
引用
收藏
页码:5726 / 5736
页数:11
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