Short-term and long-term outcomes after robot-assisted versus laparoscopic distal pancreatectomy for pancreatic neuroendocrine tumors (pNETs): a multicenter comparative study

被引：44

作者：

Alfieri, Sergio ^{[1
]}

Butturini, Giovanni ^{[2
]}

Boggi, Ugo ^{[3
]}

Pietrabissa, Andrea ^{[4
]}

Morelli, Luca ^{[3
]}

Vistoli, Fabio ^{[3
]}

Damoli, Isacco ^{[2
]}

Peri, Andrea ^{[4
]}

Fiorillo, Claudio ^{[1
]}

Pugliese, Luigi ^{[4
]}

Ramera, Marco ^{[5
]}

De Lio, Nelide ^{[3
]}

Di Franco, Gregorio ^{[3
]}

Esposito, Alessandro ^{[5
]}

Landoni, Luca ^{[5
]}

Rosa, Fausto ^{[1
]}

Menghi, Roberta ^{[1
]}

Doglietto, Giovanni Battista ^{[1
]}

Quero, Giuseppe ^{[1
,6
]}

机构：

[1] Univ Cattolica Sacro Cuore Rome, CRMPG Gemelli Pancreat Adv Res Ctr, Fdn Policlin A Gemelli IRCCS Rome, Largo Agostino Gemelli 8, I-00166 Rome, Italy

[2] Casa Cura Pederzoli, Via Monte Baldo 24, I-37019 Verona, Italy

[3] Chirurgia Gen Univ, Osped Cisanello, Via Paradisa 2, I-56124 Pisa, Italy

[4] Fdn IRCCS Policlin San Matteo, Viale Camillo Golgi 19, I-27100 Pavia, Italy

[5] Policlin GB Rossi, Dipartimento Chirurg Gen & Pancreat, Piazzale Ludovico Antonio Scuro 10, I-37134 Verona, Italy

[6] Catholic Univ Sacred Hearth, Fdn A Gemelli Hosp Rome, Dept Surg, Digest Surg Unit, Largo Agostino Gemelli 8, I-00168 Rome, Italy

来源：

LANGENBECKS ARCHIVES OF SURGERY | 2019年 / 404卷 / 04期

关键词：

Robot-assisted pancreatectomy; Pancreatic neuroendocrine tumors; Long-term outcomes; Minimally invasive; SINGLE INSTITUTIONS EXPERIENCE; INTERNATIONAL STUDY-GROUP; RESECTION; SPLEEN; NEOPLASMS; PRESERVATION; INSULINOMAS; MANAGEMENT; ENETS;

D O I：

10.1007/s00423-019-01786-x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

PurposeMinimally invasive surgery has increasingly gained popularity as a treatment of choice for pancreatectomy with encouraging initial results in robotic distal pancreatectomy (RDP). However, few data are available on the comparison between RDP and laparoscopic distal pancreatectomy (LDP) for pancreatic neuroendocrine tumors (pNETs). Our aim, thus, is to compare perioperative and long-term outcomes as well as total costs of RDP and LDP for pNETs.MethodsAll RDPs and LDPs for pNETs performed in four referral centers from 2008 to 2016 were included. Perioperative outcomes, histopathological results, overall (OS) and disease-free survival (DFS), and total costs were evaluated.ResultsNinety-six RDPs and 85 LDPs were included. Demographic and clinical characteristics were comparable between the two cohorts. Operative time was 36.5min longer in the RDP group (p=0.009) but comparable to LDP after removing the docking time (247.9 vs 233.7min; p=0.6). LDP related to a lower spleen preservation rate (44.7% vs 65.3%; p<0.0001) and higher blood loss (239.7112 vs 162.5 +/- 98cc; p<0.0001). Advantages in operative time for RDP were documented in case of the spleen preservation procedures (265 +/- 41.52 vs 291 +/- 23min; p=0.04). Conversion rate, postoperative morbidity, and pancreatic fistula rate were similar between the two groups, as well as histopathological data, OS, and DFS. Significant advantages were evidenced for LDP regarding mean total costs (9235 (+/- 1935) Euro vs 11,226 (+/- 2365) Euro; p<0.0001).Conclusions Both RDP and LDP are safe and efficacious for pNETs treatment. However, RDP offers advantages with a higher spleen preservation rate and lower blood loss. Costs still remain the main limitation of the robotic approach.

引用

页码：459 / 468

页数：10

共 46 条

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