Background

Minimally invasive surgery is now a standard treatment for gastric cancer. Many retrospective studies have reported that robotic gastrectomy is safe and feasible, with similar short- and long-term outcomes as laparoscopic gastrectomy. However, no studies have reported the details of surgical and survival outcomes for robotic gastrectomy. This study aimed to evaluate the surgical trends and techniques of robotic gastrectomy and analyze the surgical outcomes of 2000 consecutive patients with gastric cancer who underwent robotic gastrectomy over 14 years.

Methods

Between July 2005 and January 2019, 2000 consecutive robotic gastrectomies were performed. We evaluated short- and long-term outcomes as well as surgical trends after robotic gastrectomy.

Results

There were 1,560 subtotal gastrectomies (78%), 324 total gastrectomies (16.2%), 83 proximal gastrectomies (4.2%), and 33 completion total gastrectomies (1.7%). The rates of major complications and mortality were 3.1% and 0.3%, respectively. In a subgroup analysis, there were no significant differences in the rate of complications over time (P = 0.696). Five-year overall survival rates were 97.6% for stage I, 91.9% for stage II, and 69.2% for stage III, with a total recurrence rate of 5.3%. Since its adoption in 2005, the proportion of robotic gastrectomies, as well as technically demanding procedures have increased over time.

Conclusions

Our 14 years’ experience of 2000 robotic gastrectomies has shown the proportion, as well as the number of robotic gastrectomies, have tended to increase and trends toward to technically demanding procedures. Outcomes of robotic gastrectomy appear safe and feasible with acceptable short- and long-term outcomes.

中文翻译：

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胃癌机器人胃切除术后临床结果和长期生存的趋势：连续 2000 名患者的单一高容量中心经验

背景

微创手术现在是胃癌的标准治疗方法。许多回顾性研究表明机器人胃切除术是安全可行的，其短期和长期结果与腹腔镜胃切除术相似。然而，没有研究报告机器人胃切除术的手术和生存结果的细节。本研究旨在评估机器人胃切除术的手术趋势和技术，并分析 2000 名连续 14 年接受机器人胃切除术的胃癌患者的手术结果。

方法

2005 年 7 月至 2019 年 1 月期间，连续进行了 2000 次机器人胃切除术。我们评估了机器人胃切除术后的短期和长期结果以及手术趋势。

结果

有 1,560 次次全胃切除术 (78%)、324 次总胃切除术 (16.2%)、83 次近端胃切除术 (4.2%) 和 33 次完全胃切除术 (1.7%)。主要并发症发生率和死亡率分别为 3.1% 和 0.3%。在亚组分析中，随着时间的推移，并发症发生率没有显着差异（P  = 0.696）。I期5年总生存率为97.6%，II期为91.9%，III期为69.2%，总复发率为5.3%。自 2005 年采用以来，机器人胃切除术以及技术要求高的手术的比例随着时间的推移而增加。

结论

我们 2000 年机器人胃切除术的 14 年经验表明，机器人胃切除术的比例和数量有增加的趋势，并趋向于技术要求高的程序。机器人胃切除术的结果似乎是安全可行的，短期和长期结果都可以接受。