达芬奇机器人胃癌根治术临床疗效评价

Evaluation of clinical short-term outcomes of da Vinci robotic gastrectomy

目的探讨达芬奇机器人胃癌根治术的可行性及近期疗效。方法回顾性分析我科2012年2月-2014年5月手术治疗的114例胃癌患者的临床、病理资料。其中50例患者行机器人远端胃癌根治术,64例患者行腹腔镜远端胃癌根治术,比较两组患者手术情况及短期疗效。结果与腹腔镜组相比,机器人组患者术中失血量少、淋巴结清扫数目多、手术时间长,比较差异有统计学意义（P〈0.05）;术后胃肠道功能恢复时间、术后住院时间及并发症发生率,比较差异无统计学意义。中位随访16.1（3～30）个月,机器人组复发转移5例,死亡4例;腹腔镜组复发转移10例,死亡8例。结论对比腹腔镜胃切除术,达芬奇机器人胃癌根治术能获得较大的淋巴结清扫范围,且出血量少、安全、可行。

Objective To identify the technique feasibility and short-term outcomes of robotic gastrectomy. Methods The clinical and pathological data of 114 patients with gastric cancer in our department from Feb. 2012 to May 2014 were retrospectively analyzed. 50 patients who experienced robotic gastreetomy and 64 patients who underwent laparoscopic gastrectomy enrolled in this study. The operative data and short-term postoperative outcomes were compared between the groups. Results Compared with the laparoscopic group, the robotic group had less intraoperative blood loss, larger numbers of retrieved lymph nodes and longer operation time, and the differences were statistically significant （P 〈 0.05 ） . There were no significant differences in gastrointestinal function recovery time, postoperative hospital stay, and complications between the groups. During a mean follow-up period of 16. 1 （range, 3-30 ） months, 5 patients experienced relapse and metastasis , 4 patients died of the disease in robofc group, while 10 patients experienced relapse and metastasis, 8 patients died of the disease in laparoscopic group. Conclusion Compared with laparoscopic gastrectomy, robotic system for the treatment of gastric cancer is feasible and safe with the benefits of adequate lymphadenectomy, and less intraoperative blood loss.