基于倾向性匹配评分法分析达芬奇机器人与传统腹腔镜下远端根治术治疗胃癌的临床价值OA

Objective:To explore the clinical application value of Da Vinci robot or traditional laparoscopic distal radical resection in the treatment of gastric cancer based on propensity score matching.Methods:The medical records of patients with gastric cancer who received distal radical resection of gastric cancer were collected.According to the different surgical methods,they were divided into robot group(Da Vinci robotic surgery,n=85)and laparoscopic group(traditional laparoscopic surgery,n=81).The propensity score matching(1∶1 nearest neighbor matching,caliper value of 0.2)was used to balance the baseline data.Finally,63 pairs of data in each group were obtained.Both groups followed up for 6 months after surgery.The perioperative indexes(surgical time,number of lymph node dissection,postoperative first liquid diet time,abdominal drainage volume,postoperative first anal exhaust time,postoperative ambulation time,postoperative hospital stay),inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT),platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),white blood cell count(WBC)],tumor markers[cancer antigen 19-9(CA19-9),carcinoembryonic antigen(CEA)],postoperative complications and recurrence rate were compared between the two groups.Results:After treatment,the number of lymph node dissection,postoperative first anal exhaust time,abdominal drainage volume and postoperative ambulation time in robot group were better than those in laparoscopic group(P<0.05).The levels of PLR,WBC,NLR,PCT and CRP in robot group were lower compared to laparoscopic group(P<0.05).There were no statistical differences in the levels of CA19-9 and CEA,recurrence rate and incidence rates of complications between the two groups(P>0.05).Conclusion:Da Vinci robot surgery can improve the surgical efficiency and lymph node dissection effect,and reduce the postoperative inflammatory response,and it does not increase postoperative risk.