Comparison of robotic gastrectomy and laparoscopic gastrectomy in patients with normal weight and overweight

doi:10.3877/cma.j.issn.1674-6899.2018.01.012

Abstract

Abstract:

Objective

To compare the surgical outcome of robotic and laparoscopic radical gastectomy in patients with normal weight and overweight.

Methods

From Jun. 2012 to Jun. 2017, a total of 515 patients with gastric cancer who underwent robotic gastrectomy (RG, n=302) or laparoscopic gastrectomy (LG, n=213) in our department were retrospectively analysed. Patients were categorized into normal weight(body mass index <24 kg/m²) or overweight (body mass index≥24 kg/m²) group. The perioperative outcomes of RG or LG were compared in the two groups.

Results

In both normal weight and overweight group, RG shown longer operation time [(219.7 ± 40.3)min vs (190.1 ± 38.5)min, P<0.000; (238.9 ± 44.0)min vs (211.8 ± 43.8)min, P<0.000] and less estimated blood loss[(155.5 ± 198.0)ml vs (196.3 ± 172.6)ml, P<0.000; (166.6 ± 162.0)ml vs (209.4 ± 224.9)ml, P<0.000] compared with LG, while there was no significant difference in time of eating liquid diet, postoperative stay and complication rate (P> 0.05). There were more retrieved lymph nodes in the normal weight group by RG [(26.0 ± 9.6) vs (21.8 ± 9.5), P<0.000]. However, it was not significantly different in the overweight group [(22.9 ± 7.2) vs (22.3 ± 9.5), P= 0.310].

Conclusions

RG is safe and effective in both normal weight and overweight group. RG may have the advantage of more retrieved lymph nodes in the normal weight group compared with LG.

Key words: Robot, Laparoscopy, Gastrectomy, Overweight, Body mass index

Xin Liu, Peng Li, Yuansheng Liu, Hongyi Liu, Baoqing Jia. Comparison of robotic gastrectomy and laparoscopic gastrectomy in patients with normal weight and overweight[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(01): 43-46.

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Figures/Tables 4

References 14

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组别	例数	性别(例)		年龄(岁， ±s)	体质量指数(kg/m²， ±s)	ASA评分[例(%)]
组别	例数	男	女	年龄(岁， ±s)	体质量指数(kg/m²， ±s)	1分	2分	3分
腹腔镜组	121	84	37	59.6±11.9	21.2±2.0	90(74.4)	27(22.3)	4(3.3)
机器人组	155	103	52	60.1±12.3	21.7±1.9	118(76.1)	34(21.9)	3(1.9)
P值	?	0.600		0.597	0.280	0.841
组别	例数	TNM分期				手术类型[例(%)]
组别	例数	例数^a	Ⅰ期[例(%)]	Ⅱ期[例(%)]	Ⅲ期[例(%)]	远端胃	近端胃	全胃
腹腔镜组	121	120	32(26.7)	33(27.5)	55(45.8)	65(53.7)	21(17.4)	35(28.9)
机器人组	155	152	47(30.9)	31(20.4)	74(48.7)	86(55.5)	26(16.8)	43(27.7)
P值	?	0.373				0.985

组别	例数	性别(例)		年龄(岁， ±s)	体质量指数(kg/m²， ±s)	ASA评分[例(%)]
组别	例数	男	女	年龄(岁， ±s)	体质量指数(kg/m²， ±s)	1分	2分	3分
腹腔镜组	121	84	37	59.6±11.9	21.2±2.0	90(74.4)	27(22.3)	4(3.3)
机器人组	155	103	52	60.1±12.3	21.7±1.9	118(76.1)	34(21.9)	3(1.9)
P值	?	0.600		0.597	0.280	0.841
组别	例数	TNM分期				手术类型[例(%)]
组别	例数	例数^a	Ⅰ期[例(%)]	Ⅱ期[例(%)]	Ⅲ期[例(%)]	远端胃	近端胃	全胃
腹腔镜组	121	120	32(26.7)	33(27.5)	55(45.8)	65(53.7)	21(17.4)	35(28.9)
机器人组	155	152	47(30.9)	31(20.4)	74(48.7)	86(55.5)	26(16.8)	43(27.7)
P值	?	0.373				0.985

组别	例数	性别(例)		年龄(岁， ±s)	体质量指数(kg/m²， ±s)	ASA评分[例(%)]
组别	例数	男	女	年龄(岁， ±s)	体质量指数(kg/m²， ±s)	1分	2分	3分
腹腔镜组	92	71	21	60.4±11.3	26.6±2.6	61(66.3)	30(32.6)	1(1.1)
机器人组	147	123	24	59.3±9.7	26.7±2.1	95(64.6)	51(34.7)	1(0.7)
P值	?	0.211		0.643	0.217	0.895
组别	例数	TNM分期				手术类型[例(%)]
组别	例数	例数^a	Ⅰ期[例(%)]	Ⅱ期[例(%)]	Ⅲ期[例(%)]	远端胃	近端胃	全胃
腹腔镜组	92	90	23(25.6)	25(27.8)	42(46.6)	46(50.0)	24(26.1)	22(23.9)
机器人组	147	145	57(39.3)	33(22.8)	55(37.9)	70(47.6)	45(30.6)	32(21.8)
P值	?	0.096				0.747

组别	例数	性别(例)		年龄(岁， ±s)	体质量指数(kg/m²， ±s)	ASA评分[例(%)]
组别	例数	男	女	年龄(岁， ±s)	体质量指数(kg/m²， ±s)	1分	2分	3分
腹腔镜组	92	71	21	60.4±11.3	26.6±2.6	61(66.3)	30(32.6)	1(1.1)
机器人组	147	123	24	59.3±9.7	26.7±2.1	95(64.6)	51(34.7)	1(0.7)
P值	?	0.211		0.643	0.217	0.895
组别	例数	TNM分期				手术类型[例(%)]
组别	例数	例数^a	Ⅰ期[例(%)]	Ⅱ期[例(%)]	Ⅲ期[例(%)]	远端胃	近端胃	全胃
腹腔镜组	92	90	23(25.6)	25(27.8)	42(46.6)	46(50.0)	24(26.1)	22(23.9)
机器人组	147	145	57(39.3)	33(22.8)	55(37.9)	70(47.6)	45(30.6)	32(21.8)
P值	?	0.096				0.747

组别	例数	手术时间(min, ±s)	术中出血量(ml， ±s)	术中输血[例(%)]	清扫淋巴结数(枚， ±s)	术后进流食时间(d, ±s)
腹腔镜组	121	190.1±38.5	196.3±172.6	12(9.9)	21.8±9.5	7.3±2.5
机器人组	155	219.7±40.3	155.5±198.0	16(10.3)	26.0±9.6	6.9±1.9
P值	?	<0.000	<0.000	0.921	<0.000	0.150
组别	例数	术后住院时间(d, ±s)	术后并发症(例)
组别	例数	术后住院时间(d, ±s)	出血	胃排空障碍	吻合口瘘	胰瘘	急性心衰	急性肾衰	肺部感染	切口感染
腹腔镜组	121	14.1±9.1	4	2	7	1	0	1	1	1
机器人组	155	13.0±8.0	4	0	9	0	1	0	1	1
P值	?	0.159	0.947

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