Robot-assisted surgery has proven highly effective in the curative treatment of various gastrointestinal cancers. The advantages of robot-assisted surgery, including precision, enhanced operability, and magnified 3D visualization, allow surgeons to perform delicate procedures that would be challenging with conventional laparotomy or laparoscopy. These benefits make robot-assisted surgery a viable modality for treating various malignant tumors and an essential tool in curative surgery for solid cancers. Laparoscopic gastrectomy is currently the standard treatment for early gastric cancer, with numerous clinical trials assessing the efficacy of robot-assisted surgery. Although thoracoscopic esophagectomy has demonstrated advantages over open surgery in radical esophageal cancer treatment, ongoing studies are evaluating the noninferiority and potential benefits of robotic surgery. Robot-assisted surgery is also being explored for conversion surgery in cases where radical resection becomes feasible after multidisciplinary treatment and in polysurgery cases involving multiple prior laparotomies. However, establishing robust evidence for its efficacy in radical surgery for conversion and polysurgery cases remains a challenge. This narrative review discusses the advantages and limitations of robot-assisted surgery in such complex cases based on an analysis of the literature. Additionally, it examines the prospects of robotic-assisted surgery in polysurgery, metachronous remnant gastric cancer, and conversion surgery.
机器人辅助手术已被证实对多种胃肠道恶性肿瘤的根治性治疗具有显著疗效。其精准性、操作灵活性和放大的三维可视化优势，使外科医生能够完成传统开腹或腹腔镜手术难以实施的精细操作。这些优点使机器人辅助手术成为治疗多种恶性肿瘤的有效方式，也是实体肿瘤根治性手术的重要工具。目前腹腔镜胃切除术是早期胃癌的标准治疗方案，已有大量临床试验评估机器人辅助手术的疗效。虽然胸腔镜食管切除术在食管癌根治术中已显示出优于开放手术的优势，但机器人手术的非劣效性及潜在获益仍在持续研究中。对于经多学科治疗后可行根治性切除的转化手术病例，以及既往多次开腹手术的复杂病例，机器人辅助手术的应用价值也正在探索中。然而，在转化手术和复杂再手术病例的根治性治疗中，建立其有效性的坚实证据仍面临挑战。本文通过文献分析，探讨机器人辅助手术在此类复杂病例中的优势与局限，并展望其在复杂再手术、异时性残胃癌及转化手术中的应用前景。
肿瘤(癌症)患者之家