Da Vinci robot assisted total gastrectomy plus hand-sewn esophagojejunostomy for gastric carcinaoma
10.3760/cma.j.cn113855-20240706-00461
- VernacularTitle:达芬奇机器人辅助全胃切除后离断式手工食管空肠吻合的临床研究
- Author:
Wanbo HUANG
1
;
Jianming XIE
;
Jiabin YANG
;
Yongfang YIN
;
Haixiang DING
;
Xiuchong YU
;
Zhilong YAN
Author Information
1. 宁波大学医学部研究生院,宁波 315211
- Keywords:
Stomach neoplasms;
Anastomosis , surgical;
Robotic;
Gastrectomy
- From:
Chinese Journal of General Surgery
2024;39(10):758-763
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and feasibility of robot assisted total gastrectomy plus hand-sewn esophagojejunostomy.Methods:The clinical data of 72 patients diagnosed with gastric cancer and undergoing total gastrectomy at the First Affiliated Hospital of Ningbo University from Nov 2021 to May 2024 were retrospectively analyzed. They were divided into two groups: robot-assisted total gastrectomy (RATG) group, consisting of 30 patients, and laparoscopic assisted total gastrectomy (LATG) group, consisting of 42 patients . In the RATG group, the digestive tract was reconstructed by manual suture under the robot scope and Roux-Y reconstruction was performed . In LATG group, digestive tract reconstruction was performed using an in vitro stapler and Roux-Y. The clinicopathological data, perioperative indexes, and postoperative follow-up data of both groups were observed and analyzed.Results:All 72 patients successfully completed the operation without conversion to open laparotomy. The total operation time in RATG group was longer than that in LATG group [(235.2±25.8) min vs. (200.7±40.6) min, t=4.099, P<0.05)].RATG was superior to LATG group in terms of digestive tract reconstruction time, postoperative fluid intake time and hospitalization days,the difference was statistically significant [(36.9±3.0) min vs.(39.4±4.5) min, (4.2±0.5) d vs. (5.2±0.6) d、(9.5±1.6) d vs. (10.8±2.4)d, t=-2.554,-7.135,-2.595, all P<0.05]; In terms of postoperative pathology, the number of lymph node dissection in RATG group was higher than that in LATG group [(29.8±6.2) vs. (26.3±7.5), t=2.197, P<0.05]. Conclusion:The application of delayed disconnection hand-sewn esophagojejunostomy in Da Vinci robot total gastrectomy is safe and feasible for cure-intent total gastrectomy in patients of gastric carcinoma.