Comparison of the long-term outcomes of robotic radical gastrectomy for gastric cancer and conventional laparoscopic approach: a single institutional retrospective cohort study
Comparison of the long-term outcomes of robotic radical gastrectomy for gastric cancer and conventional laparoscopic approach: a single institutional retrospective cohort study
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DOI：
10.1007/s00464-016-4904-z
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发表时间：
2016-12-01
影响因子：
3.1
通讯作者：
Uyama, Ichiro
中科院分区：
文献类型：
--
作者：
Nakauchi, Masaya;Suda, Koichi;Uyama, Ichiro
机器人胃切除术（RG）治疗胃癌（GC）在过去十年中越来越多地进行。RG用于气相色谱（主要是早期气相色谱）的技术可行性和安全性已有报道；然而，很少有研究评估肿瘤预后。本研究旨在比较RG治疗胃癌与传统腹腔镜胃切除术（LG）的长期预后。在我院2009 - 2012年间521例连续行根治性胃切除术的胃癌患者中，84例连续行RG患者和437例连续行LG患者被纳入本研究。回顾性检查长期预后，包括3年总生存率（3yOS）和3年无复发生存率（3yRFS）。RG组按日本胃癌分类（IA、IB、II、III）病理分期划分的3yOS率分别为94.7%、90.9%、89.5%、62.5%。3yOS （RG, 86.9% vs. LG, 88.8%, p = 0.636）和3yRFS （RG, 86.9% vs. LG, 86.3%, p = 0.905）组间无差异。3yOS与肿瘤3年内复发密切相关（p < 0.001），而3yRFS与肿瘤大小30mm （p < 0.001）、临床分期IB （p < 0.001）、估计失血量50ml （p = 0.033）、术后胰瘘CD分级III （p = 0.035）相关。从肿瘤学角度来看，在包括相当数量晚期胃癌患者的队列中，胃癌RG是可行和安全的。
Robotic gastrectomy (RG) for gastric cancer (GC) has been increasingly performed over the last decade. The technical feasibility and safety of RG for GC, predominantly early GC, have previously been reported; however, few studies have evaluated the oncological outcomes. This study aimed to determine the long-term outcomes of RG for GC compared with those of conventional laparoscopic gastrectomy (LG).Of the 521 consecutive patients with GC who underwent radical gastrectomy at our institution between 2009 and 2012, 84 consecutive patients who underwent RG and 437 patients who received LG were enrolled in this study. Long-term outcomes including the 3-year overall survival (3yOS) and 3-year recurrence-free survival rates (3yRFS) were examined retrospectively.In the RG group, the 3yOS rates stratified by pathological stage according to the Japanese classification of gastric carcinoma (IA, IB, II, and III) were 94.7, 90.9, 89.5, and 62.5 %, respectively. No differences in 3yOS (RG, 86.9 % vs. LG, 88.8 %; p = 0.636) or 3yRFS (RG, 86.9 % vs. LG, 86.3 %; p = 0.905) were observed between the groups. 3yOS was strongly associated with cancer recurrence within 3 years (p < 0.001), while 3yRFS was associated with tumor size aeyen 30 mm (p < 0.001), clinical stage aeyen IB (p < 0.001), estimated blood loss aeyen 50 mL (p = 0.033), and postoperative pancreatic fistula CD grade aeyen III) (p = 0.035).RG for GC was feasible and safe from the oncological point of view in a cohort including a considerable number of patients with advanced GC.