The Role of Robotic Gastrectomy in the Elderly Population: A Systematic Review With Meta-analysis.

IF 1.3 4区医学 Q3 SURGERY

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2026-10-01 DOI:10.1097/SLE.0000000000001515

Dimosthenis Chrysikos, Nikolaos Taprantzis, Amir Shihada, Theodore Troupis

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引用次数: 0

Abstract

Background: As the gastric cancer patient population ages, identifying safe surgical treatments for frail elderly patients is critical. This meta-analysis evaluates the surgical safety, recovery, and oncological efficacy of robotic gastrectomy (RG) in the elderly, comparing it to laparoscopic gastrectomy (LG) in the same demographic and RG in younger patients.

Material and methods: A systematic search (PubMed, Embase, Web of Science, Scopus) identified relevant studies. Perioperative outcomes, complications, and oncological efficacy were analyzed, calculating pooled prevalences, odds ratios (ORs), and mean differences (MDs) using R.

Results: In the elderly, RG demonstrated advantages over LG, including shorter hospital stays (MD = -0.83 d), faster liquid diet transition (MD = -0.19 d, exploratory), and higher lymph node retrieval (MD = 2.68). RG had significantly fewer overall (OR = 0.72) and grade I-II complications (OR = 0.66, exploratory), and lower medical morbidities (OR = 0.53, exploratory), but required a longer operative time (MD = 19.5 min). Blood loss, mortality, and severe complications were comparable. Compared with younger RG patients, the elderly had longer hospital stays (MD = 1.18 d) and more severe (grade III-IV) complications (OR = 2.20), with no significant differences in operative time, overall complications, or mortality.

Conclusion: RG offers significant benefits for elderly gastric cancer patients, improving recovery and reducing mild complications compared with LG, without compromising oncological outcomes. Because the elderly remain inherently vulnerable to severe complications compared with younger cohorts, comprehensive preoperative functional assessment, rather than chronological age alone, is essential for optimal patient selection.

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机器人胃切除术在老年人群中的作用：一项系统综述和荟萃分析。

背景：随着胃癌患者人口的老龄化，为虚弱的老年患者寻找安全的手术治疗方法至关重要。本荟萃分析评估了机器人胃切除术（RG）在老年人中的手术安全性、恢复和肿瘤疗效，并将其与相同人群的腹腔镜胃切除术（LG）和年轻患者的RG进行了比较。材料和方法：系统检索（PubMed, Embase, Web of Science, Scopus）确定了相关研究。分析围手术期结局、并发症和肿瘤疗效，使用r计算总患病率、优势比（ORs）和平均差异（MDs）。结果：在老年人中，RG表现出优于LG的优势，包括更短的住院时间（MD = -0.83 d），更快的流质饮食过渡（MD = -0.19 d，探索性），更高的淋巴结回收（MD = 2.68）。RG总体（OR = 0.72）和I-II级并发症（OR = 0.66，探索性）明显减少，医疗发病率较低（OR = 0.53，探索性），但需要较长的手术时间（MD = 19.5 min）。出血量、死亡率和严重并发症具有可比性。与年轻RG患者相比，老年人住院时间更长（MD = 1.18 d），并发症更严重（III-IV级）（OR = 2.20），手术时间、总并发症或死亡率无显著差异。结论：与LG相比，RG可显著改善老年胃癌患者的康复，减少轻度并发症，且不影响肿瘤预后。由于与年轻人相比，老年人仍然天生容易出现严重的并发症，因此全面的术前功能评估，而不仅仅是实际年龄，对于最佳患者选择至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.