Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study

被引：24

作者：

Chen, Jeffrey ^{[1
,2
]}

van Ramshorst, Tess M. E. ^{[1
,2
,3
]}

Lof, Sanne ^{[1
,2
]}

Al-Sarireh, Bilal ^{[4
]}

Bjornsson, Bergthor ^{[5
,6
]}

Boggi, Ugo ^{[7
]}

Burdio, Fernando M. ^{[8
]}

Butturini, Giovanni ^{[9
]}

Casadei, Riccardo ^{[10
]}

Coratti, Andrea ^{[11
]}

D'Hondt, Mathieu ^{[12
]}

Dokmak, Safi ^{[13
]}

Edwin, Bjorn ^{[14
,15
]}

Esposito, Alessandro ^{[16
]}

Fabre, Jean M. ^{[17
]}

Ferrari, Giovanni ^{[18
]}

Fteriche, Fadhel S. ^{[13
]}

Fusai, Giuseppe K. ^{[19
]}

Groot Koerkamp, Bas ^{[20
]}

Hackert, Thilo ^{[21
]}

Jah, Asif ^{[22
]}

Jang, Jin-Young ^{[23
]}

Kauffmann, Emanuele F. ^{[7
]}

Keck, Tobias ^{[24
]}

Manzoni, Alberto ^{[3
]}

Marino, Marco, V ^{[25
]}

Molenaar, Quintus ^{[26
]}

Pando, Elizabeth ^{[27
]}

Pessaux, Patrick ^{[28
]}

Pietrabissa, Andrea ^{[29
]}

Soonawalla, Zahir ^{[30
,35
,36
]}

Sutcliffe, Robert P. ^{[31
]}

Timmermann, Lea ^{[32
]}

White, Steven ^{[33
]}

Yip, Vincent S. ^{[34
]}

Zerbi, Alessandro

Abu Hilal, Mohammad ^{[3
]}

Besselink, Marc G. ^{[1
,2
]}

机构：

[1] Amsterdam UMC, Locat Univ Amsterdam, Dept Surg, Amsterdam, Netherlands

[2] Canc Ctr Amsterdam, Amsterdam, Netherlands

[3] Ist Osped Fdn Poliambulanza, Dept Gen Surg, Brescia, Italy

[4] Morriston Hosp, Dept Surg, Swansea, W Glam, Wales

[5] Linkoping Univ, Dept Surg, Linkoping, Sweden

[6] Linkoping Univ, Dept Biomed & Clin Sci, Linkoping, Sweden

[7] Univ Hosp Pisa, Dept Surg, Pisa, Italy

[8] Univ Hosp Del Mar, Dept Surg, Barcelona, Spain

[9] Pederzoli Hosp, Dept Surg, Peschiera, Italy

[10] St Orsola Malphigi Hosp, Dept Surg, Bologna, Italy

[11] Careggi Univ Hosp, Div Oncol & Robot Gen Surg, Florence, Italy

[12] Groeninge Hosp, Dept Digest & Hepatobiliary Pancreat Surg, Kortrijk, Belgium

[13] Beaujon Hosp, Dept HPB Surg & Liver Transplantat, Clichy, France

[14] Univ Oslo, Oslo Univ Hosp, Intervent Ctr, Dept Surg, Oslo, Norway

[15] Univ Oslo, Inst Clin Med, Oslo, Norway

[16] Verona Univ Hosp, Pancreas Inst, Dept Gen & Pancreat Surg, Verona, Italy

[17] St Eloi Hosp, Dept Surg, Montpellier, France

[18] Osped Niguarda Ca Granda, Dept Surg, Milan, Italy

[19] Royal Free London, HPB & Liver Transplant Unit, London, England

[20] Erasmus MC, Dept Surg, Canc Inst, Rotterdam, Netherlands

[21] Heidelberg Univ Hosp, Dept Surg, Heidelberg, Germany

[22] Cambridge Univ Hosp NHS Fdn Trust, Dept HPB Surg & Transplantat, Cambridge, England

[23] Seoul Natl Univ Hosp, Dept Surg, Seoul, South Korea

[24] Univ Med Ctr Schleswig Holstein, Dept Surg, Campus Lubeck, Lubeck, Germany

[25] Azienda Osped Ospedali Riuniti Villa Sofia Cervel, Dept Emergency & Gen Surg, Palermo, Italy

[26] Univ Med Ctr Utrecht, UMC Utrecht Canc Ctr, Dept Surg, Utrecht, Netherlands

[27] Vall Hebron Univ Hosp, Dept Surg, Barcelona, Spain

[28] Inst Hosp Univ Strasbourg, Nouvel Hop Civil, Dept Hepatobiliary & Pancreat Surg, Strasbourg, France

[29] Fdn IRCCS Policlin San Matteo, Dept Surg, Pavia, Italy

[30] Oxford Univ Hosp, Dept Surg, Oxford, England

[31] Queen Elizabeth Univ Hosp Birmingham, Dept Hepatopancreatobiliary & Liver Transplant Su, Birmingham, England

[32] Charite, Dept Surg, Berlin, Germany

[33] Freeman Rd Hosp, Dept Surg, Newcastle Upon Tyne, Tyne & Wear, England

[34] Bartshealth NHS Trust, Royal London Hosp, Dept HPB Surg, London, England

[35] Humanitas Univ, Dept Surg, Milan, Italy

[36] IRCCS Humanitas Res Hosp, Milan, Italy

来源：

ANNALS OF SURGICAL ONCOLOGY | 2023年 / 30卷 / 05期

关键词：

ADENOCARCINOMA; DEFINITION; SURGERY;

D O I：

10.1245/s10434-022-13054-2

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundRobot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking.MethodsAn international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010-2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival.ResultsIn total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively.ConclusionsIn selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.

引用

页码：3023 / 3032

页数：10

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