Study on laparoscopic-assisted, totally laparoscopic, and robotic radical gastrectomy in real-world practice
10.3760/cma.j.cn431274-20250915-01183
- VernacularTitle:机器人、完全腹腔镜与腹腔镜辅助在胃癌根治术真实世界中的研究分析
- Author:
Weifeng WANG
1
;
Fang WU
;
Zaiyuan YE
;
Zhenyuan QIAN
Author Information
1. 武义县中医院外科，武义 321200
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Radical surgery;
Laparoscopically assisted;
Totally laparoscopic;
Robotic surgery
- From:
Journal of Chinese Physician
2025;27(10):1455-1458
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of laparoscopic-assisted, totally laparoscopic, and robotic radical gastrectomy (for total or distal gastrectomy) in real-world practice, clarify the advantages and disadvantages of each approach, and provide evidence for clinical surgical selection.Methods:A retrospective analysis was conducted on 225 patients who underwent radical gastrectomy for gastric cancer at the Zhejiang Provincial People′s Hospital from January 2022 to September 2023, including 100 cases of total gastrectomy and 125 cases of distal gastrectomy. Patients were divided into three groups based on the surgical approach: laparoscopic-assisted group, totally laparoscopic group, and robotic group. Perioperative indicators (operation time, intraoperative blood loss, number of lymph nodes dissected, etc.), inflammatory and nutritional indicators (C-reactive protein, white blood cell count, albumin, etc.), and postoperative recovery indicators (time to oral feeding, time to first flatus, length of hospital stay, etc.) were compared among the three groups.Results:In total gastrectomy, there were statistically significant differences among the three groups in C-reactive protein ( P<0.001), operation time ( P=0.002), time to oral feeding ( P<0.001), and intraoperative blood loss ( P<0.001). In distal gastrectomy, significant differences were observed in C-reactive protein ( P<0.001), operation time ( P<0.001), time to oral feeding ( P=0.002), and length of hospital stay ( P<0.001). No statistically significant differences were found in the incidence of postoperative complications or the number of lymph nodes dissected among the three groups (all P>0.05). Conclusions:Each of the three surgical approaches has its own advantages and disadvantages. The laparoscopic-assisted approach has low hardware requirements and shorter hospital stay after distal gastrectomy, making it suitable for widespread application. The robotic approach causes less trauma and milder inflammatory response but has high equipment and maintenance costs, requiring selection based on actual clinical conditions.
