Short-Term Clinical Outcomes After Laparoscopic and Robotic Gastrectomy for Gastric Cancer: a Propensity Score Matching Analysis.

Autor: Kong Y; Department of General Surgery, The Affiliated Hospital of Qingdao University, 16# Jiangsu Road, Qingdao, 266000, Shandong Province, People's Republic of China.; Department of Gastrointestinal Surgery, Jining No. 1 People's Hospital, No. 6 Jiankang Road, Central District, Jining City, 272013, Shandong Province, People's Republic of China.; Affiliated Jining No. 1 People's Hospital of Jining Medical University, Jining Medical University, 16# Hehua Road, Beihu New District, Jining City, 272067, Shandong, People's Republic of China., Cao S; Department of General Surgery, The Affiliated Hospital of Qingdao University, 16# Jiangsu Road, Qingdao, 266000, Shandong Province, People's Republic of China., Liu X; Department of General Surgery, The Affiliated Hospital of Qingdao University, 16# Jiangsu Road, Qingdao, 266000, Shandong Province, People's Republic of China., Li Z; Department of General Surgery, The Affiliated Hospital of Qingdao University, 16# Jiangsu Road, Qingdao, 266000, Shandong Province, People's Republic of China., Wang L; Department of General Surgery, The Affiliated Hospital of Qingdao University, 16# Jiangsu Road, Qingdao, 266000, Shandong Province, People's Republic of China., Lu C; Department of General Surgery, The Affiliated Hospital of Qingdao University, 16# Jiangsu Road, Qingdao, 266000, Shandong Province, People's Republic of China., Shen S; Department of General Surgery, The Affiliated Hospital of Qingdao University, 16# Jiangsu Road, Qingdao, 266000, Shandong Province, People's Republic of China., Zhu H; Department of General Surgery, The Affiliated Hospital of Qingdao University, 16# Jiangsu Road, Qingdao, 266000, Shandong Province, People's Republic of China., Zhou Y; Department of General Surgery, The Affiliated Hospital of Qingdao University, 16# Jiangsu Road, Qingdao, 266000, Shandong Province, People's Republic of China. zhouyanbing999@aliyun.com.
Jazyk: angličtina
Zdroj: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2020 Mar; Vol. 24 (3), pp. 531-539. Date of Electronic Publication: 2019 Apr 01.
DOI: 10.1007/s11605-019-04158-4
Abstrakt: Background: The different advantages of laparoscopic gastrectomy (LG) and robotic gastrectomy (RG), two new minimally invasive surgical techniques for gastric cancer, remain controversial.
Purpose: To compare the short-term clinical outcomes of LG and RG.
Methods: A retrospective, single-center comparative study of 1044 patients (LG = 750, RG = 294) was conducted. Patients undergoing LG and RG were matched (2:1 ratio) according to sex, age, BMI, extent of gastric resection, and pathologic stage. The primary outcomes were morbidity and mortality and perioperative recovery parameters; major types of complications were also analyzed.
Results: After matching, 798 patients (LG = 532, RG = 266) were included. Both the LG and RG groups showed similar overall complication rates (LG = 12.8% vs RG = 12.4%) and operative mortality (LG = 0.4% vs RG = 0.4%). Compared to those who underwent LG, patients undergoing RG had significantly longer operative times (236.92 ± 57.28 vs 217.77 ± 65.00 min, p < 0.001), higher total costs (US$16,241.42 vs US$12,497, p < 0.001), less operative blood loss (77.07 ± 64.37 vs 103.68 ± 86.92 ml, p < 0.001), higher numbers of retrieved lymph nodes (32.0 vs 29.9, p < 0.001), and higher rates of retrieving more than 16 lymph nodes (94.0 vs 85.5%; p < 0.001). No significant differences between groups were noted in terms of the rate of reoperation, time until a soft diet was consumed, or length of hospital stay. The major complication and readmission rates were similar in both groups.
Conclusion: RG and LG produced similar short-term clinical outcomes, indicating that RG is a safe and beneficial surgical procedure.
Databáze: MEDLINE