机器人辅助微创胃切除术（RAMIG）越来越多地用作胃癌的手术方法。本研究评估了 RAMIG 的有效性，并研究了 IDEAL 框架的哪些阶段（1 = 创意、2A = 开发、2B = 探索、3 = 评估、4 = 长期随访）。The Cochrane Library, Embase 、Pubmed 和 Web of Science 搜索了截至 2023 年 1 月关于 RAMIG 的研究。数据收集包括 IDEAL 阶段、人口统计、参与者数量和研究设计。对于随机对照试验 (RCT) 和长期研究，收集并总结了有关 RAMIG 的术中、术后和肿瘤学结果、生存率和费用的数据。在 114 项纳入的研究中，没有一项报告 IDEAL 阶段。全文阅读后，18 项 (16%) 研究被认为是 IDEAL-2A、75 项 (66%) IDEAL-2B、4 项 (4%) IDEAL-3 和 17 项 (15%) IDEAL-4。 IDEAL 阶段按顺序进行（2A-4），IDEAL-2A 研究仍在进行中。 IDEAL-3 RCT 显示总体并发症较低（RAMIG 为 8.5-9.2%，腹腔镜全胃/次全胃切除术为 17.6-19.3%）、相同的 30 天死亡率 (0%) 以及 RAMIG 的住院时间相同（平均 5.7-8.5 天） RAMIG 与 6.4-8.2 天的开腹/腹腔镜全胃/次全胃切除术）。各种技术的淋巴结产量相似，但 RAMIG 的成本明显高于腹腔镜全胃/次全胃切除术（13,423-15,262 美元 vs 10,165-10,945 美元）。 IDEAL-4 研究显示 RAMIG 具有类似或改善的总体/无病生存率。在全球 RAMIG 实施过程中，按顺序遵循 IDEAL 框架。 IDEAL-3 和 4 长期研究表明，RAMIG 在住院时间、淋巴结产量和总体/无病生存率方面与传统手术相似甚至更好。此外，尽管成本较高，RAMIG 仍显示出降低的术后并发症发生率。© 2024。作者。

Robot-assisted minimally invasive gastrectomy (RAMIG) is increasingly used as a surgical approach for gastric cancer. This study assessed the effectiveness of RAMIG and studied which stages of the IDEAL-framework (1 = Idea, 2A = Development, 2B = Exploration, 3 = Assessment, 4 = Long-term follow-up) were followed.The Cochrane Library, Embase, Pubmed, and Web of Science were searched for studies on RAMIG up to January 2023. Data collection included the IDEAL-stage, demographics, number of participants, and study design. For randomized controlled trials (RCTs) and long-term studies, data on intra-, postoperative, and oncologic outcomes, survival, and costs of RAMIG were collected and summarized.Of the 114 included studies, none reported the IDEAL-stage. After full-text reading, 18 (16%) studies were considered IDEAL-2A, 75 (66%) IDEAL-2B, 4 (4%) IDEAL-3, and 17 (15%) IDEAL-4. The IDEAL-stages were followed sequentially (2A-4), with IDEAL-2A studies still ongoing. IDEAL-3 RCTs showed lower overall complications (8.5-9.2% RAMIG versus 17.6-19.3% laparoscopic total/subtotal gastrectomy), equal 30-day mortality (0%), and equal length of hospital stay for RAMIG (mean 5.7-8.5 days RAMIG versus 6.4-8.2 days open/laparoscopic total/subtotal gastrectomy). Lymph node yield was similar across techniques, but RAMIG incurred significantly higher costs than laparoscopic total/subtotal gastrectomy ($13,423-15,262 versus $10,165-10,945). IDEAL-4 studies showed similar or improved overall/disease-free survival for RAMIG.During worldwide RAMIG implementation, the IDEAL-framework was followed in sequential order. IDEAL-3 and 4 long-term studies showed that RAMIG is similar or even better to conventional surgery in terms of hospital stay, lymph node yield, and overall/disease-free survival. In addition, RAMIG showed reduced postoperative complication rates, despite higher costs.© 2024. The Author(s).