[Comparative study on da Vince robotic and laparoscopic radical gastrectomy for gastric cancer].

摘要

OBJECTIVE: To compare the short-term clinical outcomes of laparoscopic and da Vince robotic radical gastrectomy for gastric cancer and evaluate the safety and efficacy of robotic system. METHODS: Clinical data of 200 consecutive gastric cancer patients undergoing radical gastrectomy, including 100 cases of robotic (RRG group) and 100 cases of laparoscopic (LRG group), in our department from January 2012 to May 2013 were retrospectively analyzed. Reconstruction of the alimentary tract was achieved using extracorporeal method through a minilaparotomy in LRG group, and intracorporeal robot-sewn anastomosis in RRG group. Comparative analysis between the two groups for intraoperative factors (conversion, blood loss, operative time, incision length), oncologic outcomes (TMN stage, lymph node dissection, margin) and postoperative parameters (ventilation time, hospital stay, complications, mortality) was performed. RESULT: There was only 1 conversion in LRG group. As compared to LRG group, RRG group was associated with less blood loss[(60±16) vs. (98±17) ml, P=0.005], longer operative time [(215±46) vs. (188±52) min, P=0.001], shorter incision length [(4.2±1.7) vs. (8.9±2.6) cm, P=0.028], and shorter postoperative hospital stay [(4.5±2.6) vs. (5.7±3.1) d, P=0.018] in RRG group. While there were no significant differences in other aspects between the two groups, such as number of harvested lymph nodes, distance to upper or lower margin of tumor, postoperative bowel function recovery, and postoperative complication morbidity. CONCLUSION: Robotic radical gastrectomy is feasible and safe for gastric cancer, and has better short-term and oncologic outcomes compared with laparoscopic radical gastrectomy.