达芬奇机器人胃癌根治术的近期可行性和安全性分析

Analysis of feasibility and safety of da Vinci robot radical gastrectomy for gastric cancer

目的:探讨机器人辅助胃切除术(RAG)治疗胃癌的可行性与近期安全性。方法:回顾性分析在2017年1月—2018年2月期间235例行胃癌根治性手术的患者资料,其中100例行RAG,135例行腹腔镜辅助胃切除术(LAG)。比较两组相关临床指标。结果:两组患者的人口学特征和临床病理特征相匹配。无论是全组或按BMI、切除类型和年龄所分的亚组中,RAG组均较LAG组术后住院时间减少、肛门排气时间缩短、淋巴结清扫数目增加(均P<0.05)。进一步分析发现,RAG组淋巴结清扫数目的增加主要在于第6、7、10、11p、14v组平均清扫淋巴结数目的增加(均P<0.05)。两组在手术时间、手术出血量、进流质饮食时间和术后并发症发生率方面无统计学差异(均P>0.05)。结论:RAG治疗胃癌是一种安全可行的方法,但其远期结果及预后还需更多研究来进一步评估。

Objective： To investigate the feasibility and short-term safety of robotic assisted gastrectomy （RAG） for the treatment of gastric cancer. Methods： The clinical data of 235 gastric cancer patients undergoing radical gastrectomy between January 2017 and February 2018 were retrospectively analyzed. Of the patients, 100 cases underwent RAG and 135 cases underwent laparoscopicassisted gastrectomy （LAG）. The relevant clinical variable between the two groups of patients were compared. Results： The demographic characteristics and clinicopathological features were matched between the two groups. Either in the entire group or in the subgroups stratified by BMI, resection type and age, the length of hospitalization was reduced, time to first anal gas passage was shortened, and the number of dissected lymph nodes was increased in RAG group compared with LAG group （all P〈0.05）. Further analyses showed that the increased number of dissected lymph nodes in RAG group mainly depended on the increased average numbers of dissected lymph nodes in No. 6, 7, 10, 11p and 14v lymph nodes （all P〈0.05）. There was no significant difference between the two groups in terms of operative time, surgical bleeding, time to liquid diet and incidence of postoperative complications （all P〉0.05）. Conclusion： RAG is a safe and feasible method for the treatment of gastric cancer, but its long-term results and prognosis still need to be verified by further studies.