机器人胃切除术在过去20年中取得了进展。本研究旨在(a)提供更新和全面的全面审查,包括术后结果,并发症发生率,手术效率和成本,病理学,总生存率,死亡率和复发,机器人与腹腔镜胃切除术的无病生存率,(b)报告研究差距,(c)确定正在进行或即将进行的临床试验,这些临床试验可能揭示现有文献中报道不足的发现。关于方法论,搜索PubMed和GoogleScholar进行了随机对照试验,系统评价,以及2012年1月至2023年10月发表的荟萃分析。搜索了ClinicalTrials.gov目前正在进行或招募的相关临床试验。机器人胃切除术,与腹腔镜胃切除术相比,用于治疗胃癌,在住院时间方面表现同样出色或表现出优势,总并发症发生率,开腹手术的转化率,手术并发症,吻合口漏,胰腺并发症,失血,死亡率,时间到了第一次排气,口服时间,远端和近端切除边缘,复发率,再操作率,和总体生存率。然而,它与更高的成本和更长的手术时间有关。十二指肠残端渗漏等参数,吻合口狭窄,肠梗阻,肠梗阻,胃排空延迟,伤口并发症,急性胰腺炎,胰瘘,直接成本,开始辅助化疗的时间,术后发病率,复发,和无病生存目前在文献中报道不足,需要进一步研究。最后,目前正在进行或招募四项临床试验,这可能会弥合研究差距。
Robotic gastrectomy has been gaining ground in the past 20 years. This study aims to (a) provide an updated and all-encompassing comprehensive review including post-operative outcomes, rate of complications, surgical efficiency and costs, pathology, overall survival, mortality and recurrence, and disease-free survival of robotic versus laparoscopic gastrectomy, (b) report research gaps, and (c) identify ongoing or forthcoming clinical trials that could potentially shed light on underreported findings within the existing literature. Regarding the methodology, PubMed and Google Scholar were searched for randomized controlled trials, systematic reviews, and meta-analyses published between January 2012 and October 2023. ClinicalTrials.gov was searched for related clinical trials currently underway or recruiting. Robotic gastrectomy, when compared to laparoscopic gastrectomy, for the treatment of gastric cancer, performs equally well or shows superiority in terms of the length of hospitalization, overall complications rates, rate of conversion to open surgery, surgical complications, anastomotic leakage, pancreatic complications, blood loss, mortality rates, time to first flatus, time to oral intake, distal and proximal resection margins, recurrence rate, reoperation rates, and overall survival. However, it is associated with higher costs and longer operative time. Parameters such as duodenal stump leakage, anastomosis stenosis, intestinal obstruction, ileus, delayed gastric emptying, wound complications, acute pancreatitis, pancreatic fistula, direct costs, time to initiation of adjuvant chemotherapy, postoperative morbidity, recurrence, and disease-free survival are currently underreported in the literature and necessitate for further research. Lastly, four clinical trials are currently underway or recruiting that could possibly bridge the research gap.