目的：通过与腹腔镜辅助胃切除术（Laparoscopic-assisted Gastrectomy，LAG）和开腹胃切除术（Open  Gastrectomy，OG）对比，评价机器人辅助胃切除术（Robot-assisted Gastrectomy，RAG）的优势。方法：选取西安交 通大学第一附属医院 2017 年 1 月—2019 年 7 月接受胃切除术的 147 例胃癌患者为研究对象，其中 42 例行达芬奇机 器人辅助胃癌根治术的患者为 RAG 组，44 例行腹腔镜辅助胃癌根治术的患者为 LAG 组，61 例行开腹胃癌根治术的 患者为 OG 组。比较 3 组患者的手术时间、术中失血量、清扫淋巴结数量、术后恢复、学习曲线等短期指标，以及 长期指标总生存期（Overall Survival，OS）。结果：3 组相比，机器人组术中失血量最少（P=0.033）、术后首次经 肛门排气时间最短（P<0.001）、首次摄入流食时间最短（P=0.004）、术后住院时间最短（P=0.023）、淋巴结清扫 数目最多（P=0.044），手术时间最长（P<0.001）且治疗费用最高（P<0.001）。但 3 组在术后引流、术后白细胞计 数和早期并发症方面无显著差异（P>0.05）。CUSUM 法显示，17 例后，RAG 的学习曲线达到稳定。此外，在 3 组 中 OS 结果相似。结论：与 LAG 和 OG 相比，RAG 具有一定的短期疗效优势，是一种安全可靠的手术方法。

Objective: To evaluate the advantages of robot-assisted gastrectomy (RAG) by comparing with laparoscopicassisted gastrectomy (LAG) and open gastrectomy (OG). Methods: 147 gastric cancer patients who underwent gastrectomy in  our hospital from January 2017 to July 2019 were selected into this study and retrospectively analyzed. 42 patients underwent  RAG were divided into the RAG group, 44 patients into the LAG group and 61 patients into the OG group. Short-term indicators  such as operative time, intraoperative blood loss, dissected lymph nodes, postoperative recovery, learning curve, and long-term  indicators such as overall survival (OS) of the three groups were compared. Results: Compared with the other two groups on  short-term outcomes, the RAG group had the least intraoperative blood loss (P=0.033), the shortest time to first flatus(P<0.001),  shortest time to first intake liquid diet (P=0.004), shortest postoperative hospital stay (P=0.023), the largest number of dissected  lymph nodes (P=0.044), the longest operative time (P<0.001), and the highest treatment cost (P<0.001). However, there were  no significant differences in postoperative drainage, postoperative WBC count and early complications among the three group  (P>0.05). The cumulative sum (CUSUM) method showed that learning curve of RAG reached stability after 17 cases of operation.  In addition, similar OS was observed among the three groups. Conclusion: Compared with LAG and OG, RAG has certain  advantages in short-term outcomes, which is a safe and reliable way to treat gastric cancer.

收稿日期：2022-03-16  录用日期：2022-11-28 

Received Date: 2022-03-16  Accepted Date: 2022-11-28 

基金项目：西安交通大学第一附属医院临床研究课题（XJTU1AF-CRF-2020-019） 

Foundation Item: Clinical Research Project of the First Affiliated Hospital of Xi’an Jiaotong University (XJTU1AF-CRF-2020-019) 

通讯作者：夏鹏，Email：pengxia12321@163.com Corresponding Author: XIA Peng, Email: pengxia12321@163.com 

引用格式：冯鹏，吴思渔，张惟帆，等 . 机器人、腹腔镜与开腹胃癌根治术的临床疗效对比 [J]. 机器人外科学杂志（中英文）， 2023，4（4）：350-359. 

Citation: FENG P, WU S Y, ZHANG W F, et al. Comparison of clinical efficacy on robot-assisted, laparoscopic and open radical gastrectomy for gastric cancer[J]. Chinese Journal of Robotic Surgery, 2023, 4(4): 350-359.

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