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Lower rate of conversion using robotic-assisted surgery compared to laparoscopy in completion total gastrectomy for remnant gastric cancer.
Surgical Endoscopy ( IF 3.1 ) Pub Date : 2019-05-28 , DOI: 10.1007/s00464-019-06838-3
Rana M Alhossaini 1, 2 , Abdulaziz A Altamran 1, 2 , Minah Cho 1, 2 , Chul Kyu Roh 1, 2 , Won Jun Seo 1, 2 , Seohee Choi 1, 2 , Taeil Son 1, 2 , Hyoung-Il Kim 1, 2 , Woo Jin Hyung 1, 2
Affiliation  

BACKGROUND Completion total gastrectomy with radical lymphadenectomy for remnant gastric cancer is a technically demanding procedure. No previous studies have compared laparoscopic to robotic-assisted completion gastrectomy, whereas a few small case series have reported benefits of minimally invasive surgery over open surgery. The aim of this study is to assess the effectiveness and feasibility of robotic-assisted compared with laparoscopic completion gastrectomy for the treatment of remnant gastric cancer. METHODS We retrospectively reviewed data from 55 patients who underwent minimally invasive completion gastrectomy for remnant gastric cancer at the Severance Hospital of Yonsei University Health System from April 2005 to July 2017. Of the 55 patients, 30 patients underwent laparoscopic and 25 underwent robotic-assisted completion total gastrectomy. We compared the patients' demographics, operative outcomes, and postoperative outcomes. RESULTS Operation time was longer in the robotic-assisted surgery group (225 vs 292 min, P < 0.001), but both groups had similar estimated blood loss. The laparoscopic surgery group had a 13.3% (four patients) rate of conversion to open surgery because of severe adhesions, whereas no patients in the robotic group underwent conversion to laparoscopic or open surgery (P = 0.058). Mean hospital stay, postoperative complications, and recovery were similar in both groups. Pathology results, including the number of retrieved lymph nodes, did not differ between groups. CONCLUSION Laparoscopic and robotic approaches are both feasible and safe for remnant gastric cancer, with comparable short-term outcomes. However, the robotic approach demonstrated a lower conversion rate than laparoscopy, although the statistical difference was marginal.

中文翻译:

与腹腔镜手术相比,使用机器人辅助手术完成残胃癌的全胃切除术的转化率更低。

背景技术用于残余胃癌的全胃切除术和根治性淋巴结清扫术是一项技术要求很高的手术。以前没有研究将腹腔镜手术与机器人辅助完成胃切除术进行比较,而一些小病例系列报道了微创手术优于开放手术的好处。这项研究的目的是评估与腹腔镜完全胃切除术相比,机器人辅助治疗残余胃癌的有效性和可行性。方法我们回顾性研究了2005年4月至2017年7月在延世大学卫生系统遣散医院进行的55例行微创完成胃切除术治疗残余胃癌的患者的数据。在55例患者中,30例患者接受了腹腔镜手术,其中25例接受了机器人辅助完成全胃切除术。我们比较了患者的人口统计学,手术结局和术后结局。结果机器人辅助手术组的手术时间更长(225 vs 292 min,P <0.001),但是两组的失血量相似。由于严重的粘连,腹腔镜手术组的开腹手术率为13.3%(四名患者),而机器人组中没有患者进行腹腔镜手术或开腹手术(P = 0.058)。两组的平均住院天数,术后并发症和恢复情况相似。两组之间的病理结果(包括回收的淋巴结数目)没有差异。结论腹腔镜和机器人方法对于残余胃癌既可行又安全,近期疗效相当。但是,尽管统计差异很小,但机器人方法的转化率比腹腔镜检查低。
更新日期:2020-01-14
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