A comparative study on short-term efficacy and safety between da Vinci robotic and laparoscopic gastrectomy for gastric carcinoma in a single center
10.3760/cma.j.cn113855-20240813-00527
- VernacularTitle:单中心达芬奇机器人和腹腔镜下胃癌根治术的短期疗效和安全性的对比研究
- Author:
Chi ZHANG
1
;
Yichuan FAN
;
Xiang HU
Author Information
1. 大连医科大学附属第一医院胃肠外科，大连 116011
- Keywords:
Stomach neoplasms;
Gastrectomy;
Robotic;
Laparoscopy
- From:
Chinese Journal of General Surgery
2024;39(10):752-757
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate whether robotic gastrectomy using the da Vinci surgical system offers advantages over laparoscopic surgery in short-term outcomes and safety.Methods:Clinical data were collected from 247 patients who underwent either laparoscopic or da Vinci Xi surgical system-assisted radical gastrectomy for gastric cancer at Department of Gastrointestinal Surgery, First Affiliated Hospital of Dalian Medical University between Dec 2020 and Apr 2024. Intraoperative indicators and postoperative complications were compared between the two groups.Results:The operative time was 300 (270-360) minutes in the robotic surgery group and 240 (202-280) minutes in the laparoscopic group. Intraoperative blood loss was 20 (10-30) ml and 30 (10-50) ml, respectively. The incision length was 12.0 (10.0-12.0) cm for the robotic group and 10.0 (8.0-10.8) cm for the laparoscopic group. The first postoperative anal exhaust time was 4 (3-5) days in the robotic group and 4 (4-5) days in the laparoscopic group. The time to first intake of liquid diet was 5 (4-7) days in the robotic group and 8 (6-9) days in the laparoscopic group. The time to nasogastric tube removal was 4 (3-6) days and 5 (5-8) days, respectively. Drainage tube removal occurred at 8 (6-10) days in the robotic group and 10 (9-12) days in the laparoscopic group. The postoperative hospital stay was 9 (7-11) days for the robotic group and 12 (10-14) days for the laparoscopic group (all P<0.05). There were no statistically significant differences between the two groups in terms of proximal and distal resection margins, total number of dissected lymph nodes, or the dissection number of D 1 and D 2 lymph nodes ( P>0.05). The overall complication rate was significantly lower in the robotic group (28.6%) compared to the laparoscopic group (40.5%) ( χ2=39.59, P<0.001). The lower complication rate in the robotic group was mainly due to a reduction in surgery- and abdomen-related complications (14.3% vs. 33.9%, χ2=13.04, P<0.001). The robotic group had a higher proportion of mild complications according to the Clavien-Dindo classification, specifically grade Ⅰ ( χ2=5.07, P=0.024) and grade Ⅱ ( χ2=4.41, P=0.036). Conclusion:The da Vinci surgical system is a safe and feasible option for the treatment of gastric cancer, offering superior short-term outcomes compared to laparoscopic surgery.
