机器人与腹腔镜下远端T1期胃癌根治术的临床疗效对比

Comparison of clinical efficacy between robotic and laparoscopic distal gastrectomy for T1 gastric cancer

目的:探讨机器人远端T1期胃癌根治术的可行性。方法:回顾性分析2016年1月~2020年1月广西医科大学第一附属医院胃肠腺体外科收治的行远端T1期胃癌根治术的63例患者的临床资料,其中机器人组37例,腹腔镜组26例。对比两组患者临床病理资料、术中指标及术后恢复指标。结果:两组患者资料有可比性。与腹腔镜组相比,机器人组手术时间更长([324.41±56.27)min Vs(284.19±47.56)min,P=0.004];而术中失血量(P=0.742)、淋巴结清扫数(P=0.696)、引流管拔除时间(P=0.851)、经口进食时间(P=0.483)、首次下床活动时间(P=0.335)、首次肛门排气时间(P=0.872),以及术后6h、24h、48h、72h、96h数字疼痛评分(P=0.175、P=0.753、P=0.503、P=0.632、P=0.406)、术后住院天数(P=0.108)和术后2周内并发症(P=1.000)等未见明显差异。结论:机器人应用于远端T1期胃癌根治术是安全、可行的。

Objective:To explore the feasibility of robotic distal gastrectomy for T1 Gastric Cancer.Methods:The clinical data of 63 T1 gastric cancer patients(37 patients underwent robotic distal gastrectomy and 26 patients underwent conventional laparoscopic distal gastrectomy)at the Department of Gastrointestinal Gland Surgery,the First Affiliated Hospital of Guangxi Medical University from January 2016 to January 2020 were retrospectively analyzed.The clinical pathological data,intraoperative indexes and postoperative recovery indexes of the two groups were compared.Results:Patient characteristics were well matched.Compared with the laparoscopic group,the operation time of the robot group was longer[(324.41±56.27)min Vs(284.19±47.56)min,P=0.004],while the intraoperative blood loss(P=0.742),the number of lymph node dissection(P=0.696),drainage tube removal time(P=0.851),oral feeding time(P=0.483),time to get out of bed for the first time(P=0.335),time of first anal exhaust(P=0.872),numerical rating scale of 6h,24h,48h,72h and 96h after sugery(P=0.175,0.753,0.503,0.632,0.406),postoperative hospital stays(P=0.108)and postoperative complications within 2 weeks(P=1.000)showed no significant differences.Conclusion:Robotic distal gastrectomy in treating T1 Gastric Cancer is safe and feasible.