Comparison of Short-term and Three-year Oncological Outcomes Between Robotic and Laparoscopic Gastrectomy for Gastric Cancer: A Large Multicenter Cohort Study.

Autor:	Lu J; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Li TY; Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China., Zhang L; Department of Gastric Surgery, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China., Wang ZK; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., She JJ; Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Jia BQ; Department of General Surgery, The First Medical Centre, PLA General Hospital, Beijing, China., Qin XG; Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China., Ren SY; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, China., Yao HL; Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China., Huang ZN; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Liu DN; Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China., Liang H; Department of Gastric Surgery, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China., Shi FY; Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Li P; Department of General Surgery, The First Medical Centre, PLA General Hospital, Beijing, China., Li BP; Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China., Zhang XS; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, China., Liu KJ; Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China., Zheng CH; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Huang CM; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2024 May 01; Vol. 279 (5), pp. 808-817. Date of Electronic Publication: 2024 Jan 24.
DOI:	10.1097/SLA.0000000000006215
Abstrakt:	Objective: To compare the short-term and long-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for gastric cancer. Background: The clinical outcomes of RG over LG have not yet been effectively demonstrated. Methods: This retrospective cohort study included 3599 patients with gastric cancer who underwent radical gastrectomy at eight high-volume hospitals in China from January 2015 to June 2019. Propensity score matching was performed between patients who received RG and LG. The primary end point was 3-year disease-free survival (DFS). Results: After 1:1 propensity score matching, 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 was 85.2% and 84.4%, respectively ( P =0.647). During 3 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 2 groups (all P >0.05). Sensitivity analysis showed that RG had comparable 3-year DFS (77.4% vs 76.7%, P =0.745) and overall survival (79.7% vs 78.4%, P =0.577) to LG in patients with advanced (pathologic T2-4a) disease, and the recurrence pattern within 3 years was also similar between the 2 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. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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