Copyright
©The Author(s) 2019.
World J Gastroenterol. Oct 7, 2019; 25(37): 5641-5654
Published online Oct 7, 2019. doi: 10.3748/wjg.v25.i37.5641
Published online Oct 7, 2019. doi: 10.3748/wjg.v25.i37.5641
Table 1 General clinical and pathological data of patients
Variable | All patients | Propensity score matching | ||||||||
RSPSHL | LSPSHL | P-value | RSPSHL | LSPSHL | P-value | |||||
(n = 35) | % | (n = 608) | % | (n = 35) | % | (n = 140) | % | |||
Age, yr1 | 55.3 ± 10.4 | 56.9 ± 10.6 | 0.424 | 55.3 ± 10.4 | 55.1 ± 11.5 | 0.925 | ||||
Sex | 0.345 | 0.615 | ||||||||
Female | 6 | 17.1 | 156 | 25.7 | 6 | 17.1 | 17 | 12.1 | ||
Male | 29 | 82.9 | 452 | 74.3 | 29 | 82.9 | 123 | 87.9 | ||
BMI, kg/m2[1] | 23.0 ± 2.7 | 22.2 ± 3.0 | 0.152 | 23.0 ± 2.7 | 23.1 ± 3.0 | 0.858 | ||||
ASA score | 0.014 | 0.944 | ||||||||
I | 4 | 11.4 | 186 | 30.6 | 4 | 11.4 | 19 | 13.6 | ||
II | 28 | 80.0 | 401 | 65.9 | 28 | 80.0 | 109 | 77.8 | ||
III | 3 | 8.6 | 21 | 3.5 | 3 | 8.6 | 12 | 8.6 | ||
cT classification | 0.037 | 0.211 | ||||||||
T2 | 10 | 28.6 | 100 | 16.4 | 10 | 28.6 | 22 | 15.7 | ||
T3 | 15 | 42.9 | 207 | 34.1 | 15 | 42.9 | 69 | 49.3 | ||
T4a | 10 | 28.6 | 301 | 49.5 | 10 | 28.6 | 49 | 35.0 | ||
cN classification | 0.483 | 0.541 | ||||||||
N0 | 13 | 37.1 | 212 | 34.8 | 13 | 37.1 | 57 | 40.7 | ||
N1 | 14 | 40.0 | 187 | 30.6 | 14 | 40.0 | 39 | 27.9 | ||
N2 | 4 | 11.4 | 122 | 20.0 | 4 | 11.4 | 21 | 15.0 | ||
N3 | 4 | 11.4 | 89 | 14.6 | 4 | 11.4 | 23 | 16.4 | ||
cTNM stage | 0.094 | 0.137 | ||||||||
IB | 2 | 5.7 | 55 | 9.0 | 2 | 5.7 | 13 | 9.3 | ||
IIA | 7 | 20.0 | 106 | 17.4 | 7 | 20.0 | 18 | 12.9 | ||
IIB | 13 | 37.1 | 104 | 17.1 | 13 | 37.1 | 31 | 22.1 | ||
IIIA | 7 | 20.0 | 137 | 22.5 | 7 | 20.0 | 22 | 15.7 | ||
IIIB | 3 | 8.6 | 109 | 17.9 | 3 | 8.6 | 29 | 20.7 | ||
IIIC | 3 | 8.6 | 97 | 16.0 | 3 | 8.6 | 27 | 19.3 | ||
Depth of invasion | 0.201 | 0.617 | ||||||||
pT1a | 5 | 14.3 | 31 | 5.1 | 5 | 14.3 | 10 | 7.1 | ||
pT1b | 4 | 11.4 | 52 | 8.6 | 4 | 11.4 | 24 | 17.1 | ||
pT2 | 2 | 5.7 | 55 | 9 | 2 | 5.7 | 10 | 7.1 | ||
pT3 | 16 | 45.7 | 283 | 46.5 | 16 | 45.7 | 57 | 40.7 | ||
pT4a | 8 | 22.9 | 187 | 30.8 | 8 | 22.9 | 39 | 27.9 | ||
Metastatic LNs | 0.308 | 0.649 | ||||||||
N0 | 16 | 45.7 | 194 | 31.9 | 16 | 45.7 | 54 | 38.6 | ||
N1 | 6 | 17.1 | 174 | 28.7 | 6 | 17.1 | 20 | 14.3 | ||
N2 | 6 | 17.1 | 120 | 19.7 | 6 | 17.1 | 23 | 16.4 | ||
N3 | 7 | 20.0 | 120 | 19.7 | 7 | 20.0 | 43 | 30.7 | ||
pTNM stage | 0.038 | 0.102 | ||||||||
IA | 7 | 20.0 | 44 | 7.2 | 7 | 20.0 | 29 | 20.7 | ||
IB | 3 | 8.6 | 45 | 7.4 | 3 | 8.6 | 8 | 5.7 | ||
IIA | 6 | 17.1 | 91 | 15.0 | 6 | 17.1 | 23 | 16.4 | ||
IIB | 6 | 17.1 | 93 | 15.3 | 6 | 17.1 | 16 | 11.4 | ||
IIIA | 6 | 17.1 | 122 | 20.1 | 6 | 17.1 | 8 | 5.7 | ||
IIIB | 2 | 5.7 | 149 | 24.5 | 2 | 5.7 | 31 | 22.1 | ||
IIIC | 5 | 14.3 | 64 | 10.5 | 5 | 14.3 | 25 | 17.9 | ||
Charlson score | 0.467 | 0.132 | ||||||||
0 | 25 | 71.5 | 439 | 72.2 | 25 | 71.5 | 90 | 64.3 | ||
1 | 6 | 17.1 | 129 | 21.2 | 6 | 17.1 | 43 | 30.7 | ||
≥2 | 4 | 11.4 | 40 | 6.6 | 4 | 11.4 | 7 | 5.0 | ||
Primary site | 0.458 | 0.335 | ||||||||
Upper | 21 | 60.0 | 402 | 66.1 | 21 | 60.0 | 96 | 68.6 | ||
Middle | 14 | 40.0 | 206 | 33.9 | 14 | 40.0 | 44 | 31.4 |
Table 2 Operative outcomes after propensity score matching
Variable | RSPSHL (n = 35) | % | LSPSHL (n = 140) | % | P-value |
Total operative time, min1 | 221.3 ± 40.3 | 189.1 ± 43.8 | <0.001 | ||
Docking time, min2 | 30 (26-34) | - | |||
OR time, min1 | 186.0 ± 35.3 | 189.1 ± 43.8 | 0.698 | ||
EBL, mL1 | 13.7 ± 4.3 | 62.4 ± 29.3 | <0.001 | ||
SHDT, min1 | 20.4 ± 4.5 | 24.1 ± 8.9 | 0.018 | ||
First step, min1 | 8.4 ± 3.5 | 8.7 ± 4.0 | 0.685 | ||
Second step, min1 | 6.7 ± 2.6 | 9.8 ± 5.6 | 0.002 | ||
Third step, min1 | 5.2 ± 2.1 | 5.6 ± 3.0 | 0.458 | ||
SHBL, mL1 | 2.2 ± 1.9 | 10.0 ± 4.5 | <0.001 | ||
No. of SGVs1 | 3.5 ± 1.2 | 3.6 ± 1.1 | 0.637 | ||
No. of PGAs (yes) | 22 | 62.9 | 81 | 57.9 | 0.591 |
No. of SUPAs (yes) | 4 | 11.4 | 20 | 14.3 | 0.870 |
No. of SLPAs (yes) | 1 | 2.9 | 7 | 5 | 0.928 |
Terminal branches of SpA | 0.754 | ||||
Concentrated type | 23 | 65.7 | 88 | 62.9 | |
Distributed type | 12 | 34.3 | 52 | 37.1 | |
Splenic injury | 3 | 8.6 | 19 | 13.6 | 0.608 |
Vascular injury | 7 | 20 | 17 | 12.1 | 0.350 |
No.10 metastatic LN | 4 | 11.4 | 15 | 10.7 | 0.855 |
No.10 retrieved LN1 | 3.1 ± 1.4 | 3.3 ± 2.5 | 0.650 | ||
Total retrieved LNs1 | 37.8 ± 13.1 | 40.6 ± 13.6 | 0.274 |
Table 3 Noncompliance rate of nodal dissection between robotic spleen-preserving splenic hilar lymphadenectomy and laparoscopic spleen-preserving splenic hilar lymphadenectomy
Variable | RSPSHL | LSPSHL | P-value | ||
Compliant | Noncompliant | Compliant | Noncompli-ant | ||
cT classification | |||||
cT2 | 3 | 7 | 6 | 16 | 0.791 |
cT3 | 6 | 9 | 31 | 39 | 0.761 |
cT4 | 4 | 6 | 19 | 29 | 0.741 |
cN classification | |||||
cN0 | 4 | 9 | 22 | 36 | 0.868 |
cN1 | 6 | 8 | 15 | 23 | 0.825 |
cN2 | 2 | 2 | 11 | 10 | 0.647 |
cN3 | 1 | 3 | 8 | 15 | 0.848 |
cTNM stage | |||||
I | 1 | 1 | 5 | 8 | 1.000 |
II | 9 | 16 | 18 | 31 | 0.950 |
III | 3 | 5 | 33 | 45 | 0.909 |
BMI, kg/m2 | |||||
< 25 | 11 | 14 | 38 | 68 | 0.449 |
≥ 25 | 2 | 8 | 18 | 16 | 0.139 |
Total | 13 | 22 | 56 | 84 | 0.757 |
Table 4 Short-term operative outcomes and postoperative complications according to the Clavien–Dindo classification
Variable | RSPSHL (n = 35) | % | LSPSHL (n = 140) | % | P-value |
Time to ambulation, d1 | 2.4 ± 0.9 | 2.1 ± 1.0 | 0.107 | ||
Flatus passage, d1 | 3.2 ± 0.9 | 3.5 ± 1.3 | 0.199 | ||
Liquid diet, d1 | 4.8 ± 1.1 | 5.4 ± 1.7 | 0.049 | ||
Soft diet, d1 | 7.0 ± 2.4 | 7.5 ± 1.5 | 0.125 | ||
Drain removal, d1 | 9.2 ± 2.1 | 9.6 ± 2.0 | 0.296 | ||
Nasojejunal tube removal, d1 | 3.9 ± 1.6 | 4.8 ± 2.5 | 0.044 | ||
LOS, d1 | 14.7 ± 13.4 | 14.4 ± 11.5 | 0.894 | ||
Overall complications | 5 | 14.3 | 25 | 17.9 | 0.616 |
Grade I–II | 3 | 8.6 | 17 | 12.1 | 0.632 |
Anastomotic fistula | 2 | 5.7 | 3 | 2.1 | |
Digestive hemorrhage | - | 1 | 0.7 | ||
Lymphatic fistula | - | 6 | 4.3 | ||
Intestinal obstruction | - | 1 | 0.7 | ||
Intraperitoneal infection | 1 | 2.9 | 4 | 2.9 | |
Wound infection | - | 1 | 0.7 | ||
Fat liquefaction | - | 1 | 0.7 | ||
Grade III-IV | 2 | 5.7 | 8 | 5.7 | 1 |
Anastomotic fistula | - | 1 | 0.7 | ||
Digestive hemorrhage | 1 | 2.9 | 3 | 2.1 | |
Lymphatic fistula | - | 2 | 1.4 | ||
Intestinal obstruction | - | 1 | 0.7 | ||
Intraperitoneal infection | 1 | 2.9 | 1 | 0.7 | |
30-day mortality | 0 | 0 | |||
In-hospital mortality | 0 | 0 |
Table 5 Time difference between the first and second steps among robotic spleen-preserving splenic hilar lymphadenectomy patients
- Citation: Wang JB, Liu ZY, Chen QY, Zhong Q, Xie JW, Lin JX, Lu J, Cao LL, Lin M, Tu RH, Huang ZN, Lin JL, Zheng HL, Que SJ, Zheng CH, Huang CM, Li P. Short-term efficacy of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy via Huang's three-step maneuver for advanced upper gastric cancer: Results from a propensity score-matched study. World J Gastroenterol 2019; 25(37): 5641-5654
- URL: https://www.wjgnet.com/1007-9327/full/v25/i37/5641.htm
- DOI: https://dx.doi.org/10.3748/wjg.v25.i37.5641