Clinical Feasibility of Vascular Navigation System During Laparoscopic Gastrectomy for Gastric Cancer: A Retrospective Comparison With Propensity-Score Matching.

IF 3.2 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Ji Eun Jung, Jeong Ho Song, Seyeol Oh, Sang-Yong Son, Hoon Hur, In Gyu Kwon, Sang-Uk Han
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Abstract

Purpose: The usability of a new surgical navigation system that provides patient-specific vascular information for robotic gastrectomy in gastric cancer remains unexplored for laparoscopic gastrectomy owing to differences in surgical environments. This study aimed to evaluate the applicability and safety of this navigation system in laparoscopic gastrectomy and to compare the post-operative outcomes between procedures with and without its use.

Materials and methods: Between June 2022 and July 2023, 38 patients across 2 institutions underwent laparoscopic gastrectomy using a navigation system (navigation group). The technical feasibility, safety, and accuracy of detecting variations in vascular anatomy were measured. The perioperative outcomes were compared with 114 patients who underwent laparoscopic gastrectomy without a navigation system (non-navigation group) using 1:3 propensity score matching during the same study period.

Results: In all patients in the navigation group, no adverse events associated with the navigation system occurred during surgery in any patient in the navigation group. No accidental vessel injuries necessitate auxiliary procedures. All vessels encountered during the gastrectomy were successfully reconstructed and visualized. Patient demographics and operative data were comparable between the 2 groups. The navigation group exhibited a significantly lower overall complication rate (10.5%) than the non-navigation group (26.3%, P=0.043). Notably, pancreas-related complications were absent in the navigation group but occurred in eight cases in the non-navigation group (7.0%, P=0.093), although the difference was not statistically significant.

Conclusions: The patient-specific surgical navigation system demonstrated clinical feasibility and safety for laparoscopic gastrectomy for gastric cancer, potentially reducing complication rates compared with laparoscopic gastrectomy without its use.

腹腔镜胃癌切除术中血管导航系统的临床可行性:倾向分数匹配的回顾性比较
目的:由于手术环境的差异,在腹腔镜胃癌机器人胃切除术中,提供患者特异性血管信息的新型手术导航系统的可用性仍有待探索。本研究旨在评估该导航系统在腹腔镜胃切除术中的适用性和安全性,并比较使用和未使用该系统的手术的术后效果:2022年6月至2023年7月期间,两家机构的38名患者使用导航系统接受了腹腔镜胃切除术(导航组)。测量了技术可行性、安全性和检测血管解剖变异的准确性。在同一研究期间,采用1:3倾向得分匹配法将围术期结果与114名未使用导航系统接受腹腔镜胃切除术的患者(非导航组)进行了比较:结果:在导航组的所有患者中,没有任何患者在手术过程中发生与导航系统相关的不良事件。没有意外的血管损伤需要进行辅助手术。胃切除术中遇到的所有血管均成功重建并显露出来。两组患者的人口统计学和手术数据相当。导航组的总体并发症发生率(10.5%)明显低于非导航组(26.3%,P=0.043)。值得注意的是,导航组未出现胰腺相关并发症,但非导航组出现了8例(7.0%,P=0.093),尽管差异无统计学意义:患者特异性手术导航系统证明了腹腔镜胃切除术治疗胃癌的临床可行性和安全性,与未使用该系统的腹腔镜胃切除术相比,有可能降低并发症发生率。
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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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