Robotic vs laparoscopic distal gastrectomy with D2 lymphadenectomy for gastric cancer: a retrospective comparative mono-institutional study.
Robotic vs laparoscopic distal gastrectomy with D2 lymphadenectomy for gastric cancer: a retrospective comparative mono-institutional study.
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DOI：
10.1186/s12893-016-0180-z
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发表时间：
2016-09-20
期刊：
影响因子：
1.9
通讯作者：
Perigli G
中科院分区：
文献类型：
--
作者：
Cianchi F;Indennitate G;Trallori G;Ortolani M;Paoli B;Macrì G;Lami G;Mallardi B;Badii B;Staderini F;Qirici E;Taddei A;Ringressi MN;Messerini L;Novelli L;Bagnoli S;Bonanomi A;Foppa C;Skalamera I;Fiorenza G;Perigli G
机器人手术的发展是为了提高手术质量，克服传统腹腔镜在复杂的微创手术中的局限性。本研究旨在比较机器人远端胃切除术和腹腔镜远端胃切除术治疗胃癌的疗效。2008年6月至2015年9月，同一机构的一名外科医生进行了41例腹腔镜手术和30例机器人远端胃切除术。前瞻性地收集患者的临床病理特征、手术操作、术后发病率/死亡率和病理资料，并用卡方检验和Mann-Whitney检验对两组进行比较。两组患者的特征无显著差异。腹腔镜组肿瘤平均直径(5.3±0.5)cm，明显大于机器人手术组(3.0±0.4)cm(P=0.02)。然而，两组患者的肿瘤分期分布相似。机器人组平均清扫淋巴结数明显高于腹腔镜组(39.1±3.7和30.5±2.0，P=0.02)。平均手术时间腹腔镜组为262.6±8.6min，机器人组为312.6±15.7min(P<；0.001)。与手术相关和与手术无关的并发症在腹腔镜组和机器人组中的发生率相似。两组患者的短期临床结果无显著差异。在小规模、非随机分析的范围内，我们的研究证实了机器人远端胃切除术是一种可行且安全的外科手术。与传统的腹腔镜术相比，机器人手术在淋巴清扫术中表现出明显的优势，可以提取和检查更多的淋巴结。
Robotic surgery has been developed with the aim of improving surgical quality and overcoming the limitations of conventional laparoscopy in the performance of complex mini-invasive procedures. The present study was designed to compare robotic and laparoscopic distal gastrectomy in the treatment of gastric cancer. Between June 2008 and September 2015, 41 laparoscopic and 30 robotic distal gastrectomies were performed by a single surgeon at the same institution. Clinicopathological characteristics of the patients, surgical performance, postoperative morbidity/mortality and pathologic data were prospectively collected and compared between the laparoscopic and robotic groups by the Chi-square test and the Mann-Whitney test, as indicated. There were no significant differences in patient characteristics between the two groups. Mean tumor size was larger in the laparoscopic than in the robotic patients (5.3 ± 0.5 cm and 3.0 ± 0.4 cm, respectively; P = 0.02). However, tumor stage distribution was similar between the two groups. The mean number of dissected lymph nodes was higher in the robotic than in the laparoscopic patients (39.1 ± 3.7 and 30.5 ± 2.0, respectively; P = 0.02). The mean operative time was 262.6 ± 8.6 min in the laparoscopic group and 312.6 ± 15.7 min in the robotic group (P < 0.001). The incidences of surgery-related and surgery-unrelated complications were similar in the laparoscopic and in the robotic patients. There were no significant differences in short-term clinical outcomes between the two groups. Within the limitation of a small-sized, non-randomized analysis, our study confirms that robotic distal gastrectomy is a feasible and safe surgical procedure. When compared with conventional laparoscopy, robotic surgery shows evident benefits in the performance of lymphadenectomy with a higher number of retrieved and examined lymph nodes.
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DOI：
10.1007/s00464-014-3547-1
发表时间：
2014-10-01
影响因子：
3.1
作者：
Shen, Wei-Song;Xi, Hong-Qing;Wei, Bo
通讯作者：
Wei, Bo
影响因子：
2.5
作者：
Ding, Jie;Liao, Guo-Qing;Tang, Jing
通讯作者：
Tang, Jing
影响因子：
9
作者：
Kitano, Seigo;Shiraishi, Norio;Tanigawa, Nobuhiko
通讯作者：
Tanigawa, Nobuhiko
DOI：
10.1007/s00464-015-4069-1
发表时间：
2015-11-01
影响因子：
3.1
作者：
Lee, Juhan;Kim, Yoo-Min;Hyung, Woo Jin
通讯作者：
Hyung, Woo Jin
影响因子：
2.6
作者：
Koeda, Keisuke;Nishizuka, Satoshi;Wakabayashi, Go
通讯作者：
Wakabayashi, Go