臨床外科77巻4号

2022年04月発行

特集 そろそろ真剣に考えよう　胃癌に対するロボット支援手術 ロボット支援手術を始めるために

今，なぜ胃癌にロボット支援手術を行うのか—胃癌に対するロボット支援手術のエビデンス

著者： 小濱和貴¹ 久森重夫¹ 錦織達人¹ 星野伸晃¹ 住井敦彦¹ 角田茂¹

所属機関： ¹京都大学消化管外科

ページ範囲：P.384 - P.387

【ポイント】
◆ロボット支援胃癌手術の短期成績に関するエビデンスが報告されつつあるが，合併症軽減についてはまだ議論の余地がある．
◆ロボット支援胃癌手術のラーニングカーブは25例程度であるが，その途上の合併症発生には十分留意する必要がある．
◆Surgeon autonomyという考え方は，ロボット支援手術のアドバンテージを理解するうえで重要なコンセプトである．

参考文献

1）Uyama I, Suda K, Nakauchi M, et al：Clinical advantages of robotic gastrectomy for clinical stage Ⅰ/Ⅱ gastric cancer：a multi-institutional prospective single-arm study. Gastric Cancer 22：377-385, 2019

2）Kim HI, Han SU, Yang HK, et al：Multicenter prospective comparative study of robotic versus laparoscopic gastrectomy for gastric adenocarcinoma. Ann Surg 263：103-109, 2016

3）Ojima T, Nakamura M, Hayata K, et al：Short-term outcomes of robotic gastrectomy vs laparoscopic gastrectomy for patients with gastric cancer：A randomized clinical trial. JAMA Surg 156：954-963, 2021

4）Lu J, Zheng CH, Xu BB, et al：Assessment of robotic versus laparoscopic distal gastrectomy for gastric cancer：A randomized controlled trial. Ann Surg 273：858-867, 2021

5）Shibasaki S, Suda K, Nakauchi M, et al：Non-robotic minimally invasive gastrectomy as an independent risk factor for postoperative intra-abdominal infectious complications：A single-center, retrospective and propensity score-matched analysis. World J Gastroenterol 26：1172-1184, 2020

6）Hikage M, Fujiya K, Kamiya S, et al：Robotic gastrectomy compared with laparoscopic gastrectomy for clinical stage Ⅰ/Ⅱ gastric cancer patients：A propensity score-matched analysis. World J Surg 45：1483-1494, 2021

7）Li ZY, Zhou YB, Li TY, et al：Robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer：A multicenter cohort study of 5402 patients in China. Ann Surg 2021 Jul 2［Online ahead of print］

8）Jin T, Liu HD, Yang K, et al：Effectiveness and safety of robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer：a meta-analysis of 12,401 gastric cancer patients. Updates Surg 2021 Oct 16［Online ahead of print］

9）Suda K, Yamamoto H, Nishigori T, et al：Safe implementation of robotic gastrectomy for gastric cancer under the requirements for universal health insurance coverage：a retrospective cohort study using a nationwide registry database in Japan. Gastric Cancer 2021 Oct 12［Online ahead of print］

10）Obama K, Kim YM, Kang DR, et al：Long-term oncologic outcomes of robotic gastrectomy for gastric cancer compared with laparoscopic gastrectomy. Gastric Cancer 21：285-295, 2018

11）Nakauchi M, Suda K, Shibasaki S, et al：Comparison of the long-term outcomes of robotic radical gastrectomy for gastric cancer and conventional laparoscopic approach：a single institutional retrospective cohort study. Surgical Endoscopy 30：5444-5452, 2016

12）Nakauchi M, Suda K, Shibasaki S, et al：Prognostic factors of minimally invasive surgery for gastric cancer：Does robotic gastrectomy bring oncological benefit? World J Gastroenterol 27：6659-6672, 2021

13）Choi S, Song JH, Lee S, et al：Surgical merits of open, laparoscopic, and robotic gastrectomy techniques with D2 lymphadenectomy in obese patients with gastric cancer. Ann Surg Oncol 28：7051-7060, 2021

14）Li ZY, Qian F, Shi Y, et al：Learning curve of robotic distal and total gastrectomy. Br J Surg 108：1126-1132, 2021

15）Kim MS, Kim WJ, Hyung WJ, et al：Comprehensive learning curve of robotic surgery：discovery from a multicenter prospective trial of robotic gastrectomy. Ann Surg 273：949-956, 2021

16）Solaini L, D'Ignazio A, Marrelli D, et al：The effect of learning curve on perioperative outcomes of robotic gastrectomy in two western high-volume centers. Int J Med Robot 17：e2212, 2021

17）Chen QY, Zhong Q, Liu ZY, et al：Surgical outcomes, technical performance and surgery burden of robotic total gastrectomy for locally advanced gastric cancer：A prospective study. Ann Surg 2021 Jan 22

18）Dalsgaard T, Jensen MD, Hartwell D, et al：Robotic surgery is less physically demanding than laparoscopic surgery：paired cross sectional study. Ann Surg 271：106-113, 2020