Comparison of Short-term and Three-year Oncological Outcomes Between Robotic and Laparoscopic Gastrectomy for Gastric Cancer

医学 胃切除术 普通外科 癌症 期限(时间) 腹腔镜检查 外科 内科学 量子力学 物理
作者
Jun Lü,Taiyuan Li,Li Zhang,Zu‐Kai Wang,Junjun She,Baoqing Jia,Xin‐Gan Qin,Shuangyi Ren,Hongliang Yao,Ze‐Ning Huang,Dongning Liu,Liang Han,Feiyu Shi,Peng Li,Bopei Li,Xinsheng Zhang,Kuijie Liu,Chao‐Hui Zheng,Chang‐Ming Huang
出处
期刊:Annals of Surgery [Lippincott Williams & Wilkins]
被引量:8
标识
DOI:10.1097/sla.0000000000006215
摘要

Objective: To compare the short- and long-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for gastric cancer. Summary Background Data: The clinical outcomes of RG over LG have not yet been effectively demonstrated. Methods: This retrospective cohort study included 3,599 patients with gastric cancer who underwent radical gastrectomy at eight high-volume hospitals in China from August 2016 to June 2019. Propensity score matching (PSM) was performed between patients who received RG and LG. The primary endpoint was 3-year disease-free survival (DFS). Results: After 1:1 PSM, 1034 pairs of patients were enrolled in a balanced cohort for further analysis. The 3-year DFS in the RG and LG was 83.7% and 83.1% ( P =0.745), respectively, and the 3-year overall survival (OS) was 85.2% and 84.4%, respectively ( P =0.647). During three years of follow-up, 154 patients in the RG and LG groups relapsed (cumulative incidence of recurrence: 15.0% vs. 15.0%, P =0.988). There was no significant difference in the recurrence sites between the two groups (all P >0.05). Sensitivity analysis showed that RG had comparable 3-year DFS (77.4% vs. 76.7%, P =0.745) and OS (79.7% vs. 78.4%, P =0.577) to LG in patients with advanced (pathological T2-4a) disease, and the recurrence pattern within three years was also similar between the two groups (all P >0.05). RG had less intraoperative blood loss, lower conversion rate, and shorter hospital stays than LG (all P >0.05). Conclusions: For resectable gastric cancer, including advanced cases, RG is a safe approach with comparable 3-year oncological outcomes to LG when performed by experienced surgeons.
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