不同体质量指数胃癌患者行机器人与腹腔镜胃癌根治术近期疗效对比

Comparison of short-term efficacy between robotic and laparoscopic radical gastrectomy for gastric cancer patients with different body mass index

目的对比不同体质量指数(body mass index,BMI)胃癌患者行机器人与腹腔镜胃癌根治术的近期疗效。方法收集2021年1月至2022年6月于南昌大学第一附属医院普外七病区收治的行手术治疗的443例胃癌患者的临床病理资料。其中消瘦组68例、正常组238例、超重组137例,比较三组患者行机器人与腹腔镜胃癌根治术的基线资料、病理资料、术中及术后短期疗效。结果消瘦组里:机器人组的术后进食时间要更短[3(2,3)vs.3(3,4)]d。正常组里:机器人组患者显著缩短了手术总时间[172(144,205)vs.215(175,259)]min包括分离和重建时间、进食留置的时间[3(3,4)vs.3(3,5)]d、引流管拔除的时间[6(6,8)vs.7(6,8)]d及术后住院时间[8(7,10)vs.7(7,9)]d。超重组里:机器人组缩短了手术总时间[190(170,237)vs.240(192,297)]min包括分离和重建时间、引流管拔除的时间[6(6,7)vs.6(5,6)]d,术后住院时间[7(7,8)vs.7(6,7)]d,清扫更多的胃外站淋巴结[(14.3±10.6)vs.(10.6±6.9)]。机器人组的总费用比腹腔镜组贵约13000元。其余对比均差异无统计学意义(P>0.05)。结论机器人操作系统能够带给高BMI值的胃癌患者更多短期获益,BMI值应该作为胃癌根治术术前选择操作系统时予以考量的一个指标。

Objective To compare the short-term efficacy of robotic versus laparoscopic radical gastrectomy in gastric cancer patients with varying Body Mass Index(BMI).Methods From January 2021 to June 2022,the clinicopathological data of 443 patients with gastric cancer who underwent surgical treatment in the Seventh General Ward of the First Affiliated Hospital of Nanchang University were collected.Among them,there were 68 cases in the lean group,238 cases in the normal group,and 137 cases in the overweight group.The three groups were compared in terms of baseline data,pathological data,intraoperative and postoperative short-term efficacy of robotic and laparoscopic radical gastrectomy.Results In the lean group,the robotic group had a shorter postoperative eating time[3(2,3)vs.3(3,4)]days.In the normal group:patients in the robotic group significantly shortened the total operation time[172(144,205)vs.215(175,259)]min including separation and reconstruction time,time for eating and indwelling[3(3,4)vs.3(3,5)]days,drainage tube removal time[6(6,8)vs.7(6,8)]days and postoperative hospital stay[8(7,10)vs.7(7,9)]days.In the overweight group,the robotic group reduced total operative time[190(170,237)vs.240(192,297)]min including dissection and reconstruction time,drain removal time[6(6,7)vs.6(5,6)]days,postoperative hospital stay[7(7,8)vs.7(6,7)]days and removed more extragastric lymph nodes[14.3±10.6 vs.10.6±6.9].Conclusion Robotic operating systems can provide more immediate benefits to gastric cancer patients with high BMI values,and BMI should be considered as an indicator when selecting an operating system before undergoing a radical gastrectomy for gastric cancer.