ZHANG Yichao 1,2 , XU Boyu 2 , ZHU Jun 1 , QIAO Yihuan 1,2 , MA Qian 1,2 , LI Jipeng 1
  • 1. Department of Digestive Surgery, Xijing Hospital, First Affiliated Hospital of Air Force Military Medical University, Xi’an 710032, P. R. China;
  • 2. Xi’an Medical University, Xi’an 710068, P. R. China;
LI Jipeng, Email: jipengli1974@aliyun.com
gastric cancer; DaVinci robotic surgery; laparoscope; propensity score matching; curative effect
10.7507/1007-9424.202110068
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Objective  To investigate the clinical effect of the DaVinci robot system and laparoscopic radical gastrectomy. Methods  Propensity score matching and retrospective cohort study were adopted. Data of 446 patients who underwent robotic or laparoscopic radical gastrectomy in the Department of Gastrointestinal Surgery, Xijing Hospital, the First Affiliated Hospital of Air Force Military Medical University from January 2014 to April 2021 were collected. Among them, 174 cases underwent robotic and 272 cases underwent laparoscopic surgery. Using the method of propensity score matching, 133 cases were selected from robotic operation group and laparoscopic operation group respectively as the research object. The perioperative indexes of the two groups were compared. Kaplan-Meier survival analysis was used to draw the survival curve and calculate the survival rate. Cox regression model was used to analyze the risk factor of prognosis. Results  There was no significant difference in baseline data between the robotic surgery group and the laparoscopic surgery group after propensity score matching (P>0.05). The operative time of the two groups [(236.47±50.32) min vs. (230.64±44.51) min, t=1.000, P=0.318], the number of lymph nodes dissected [(23.32±6.58) vs. (23.95±6.03), t=–0.826, P=0.410], the time of first anal exhaust [(3.46±0.77) days vs. (3.38±0.75) days, t=0.882, P=0.378], and the length of postoperative hospital stay [(6.98±2.84) days vs. (6.94±3.61) days, t=0.094, P=0.925] were similar, the differences were not statistically significant. Compared with the laparoscopic surgery group, the robotic surgery group had less intraoperative bleeding [(83.76±58.23) mL vs. (116.54±58.58) mL, t=–4.577, P<0.001], but the total hospitalization expenses was higher [(10.04±1.92) ten-thousand Yuan vs. (6.80±1.27) ten-thousand Yuan, t=16.211, P<0.001]. The incidence of postoperative complications between the two groups (χ2=0.057, P=0.812) and Clavien-Dindo classification of complications (Z=–0.440, P=0.965) were similar between the two groups, the differences were not statistically significant. The 3-year survival situation was similar between the two groups (P=0.356). Body mass index [RR=0.803, 95%CI (0.698, 0.924), P=0.002], TNM-staging [Ⅱ -stage vs.Ⅰ -stage, RR=4.152, 95%CI (1.121, 15.385), P=0.033; Ⅲ -stage vs.Ⅰ -stage, RR=5.476, 95%CI (1.458, 20.558), P=0.012] and postoperative complications [with vs. without, RR=3.262, 95%CI (1.283, 8.293), P=0.013] were prognostic factors for 3-year survival. Conclusion  Compared with laparoscopic radical gastrectomy, robotic radical gastrectomy has the same short-term and long-term prognosis.

Citation： ZHANG Yichao, XU Boyu, ZHU Jun, QIAO Yihuan, MA Qian, LI Jipeng. Efficacy analysis of robotic and laparoscopic radical gastrectomy based on propensity score matching. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(8): 1054-1060. doi: 10.7507/1007-9424.202110068 Copy

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