Delayed gastric emptying after pylorus-preserving pancreatoduodenectomy: Comparison between traditional open surgery and full-robotic approach with da Vinci Xi

IF 2.3 3区医学 Q2 SURGERY International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2023-09-01 DOI:10.1002/rcs.2571

Luca Morelli, Gregorio Di Franco, Niccolò Furbetta, Matteo Palmeri, Simone Guadagni, Desirée Gianardi, Cristina Carpenito, Annalisa Comandatore, Elisa Giovannetti, Giulio Di Candio, Alfred Cuschieri

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Abstract

Introduction

Delayed gastric emptying (DGE) is a frequent complication after pancreatoduodenectomy, especially after pylorus preservation (Pp). We evaluated the effect of a fully robotic approach with da Vinci Xi on DGE after PpPD.

Methods

Open and robotic PDs were performed in 353 and 50 cases, respectively, from January 2009 to March 2022. We compared the clinical outcomes and incidence of clinically relevant DGE between robotic PpPD (R-PpPD) and open PpPD after one-to-one case-control matching.

Results

Each group consisted of 30 patients. Clinically relevant DGE was less common after R-PpPD (3/30 [10%] vs. 10/30 cases [33.3%], p = 0.028). The median length of hospital stay (LoS) was significantly lower in the R-PpPD group (10 vs. 15 days, p = 0.013).

Conclusion

The reduced tissue trauma by the minimally invasive robotic approach is associated with a lower incidence of DGE, reducing the LoS and encouraging PpPD performed using the fully robotic approach.

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保留幽门的胰十二指肠切除术后的胃排空延迟：传统开放手术与达芬奇Xi全机器人手术的比较

导言胃排空延迟（DGE）是胰十二指肠切除术后经常出现的并发症，尤其是在保留幽门（Pp）术后。我们评估了达芬奇Xi全机器人手术对胰十二指肠切除术后DGE的影响。方法从 2009 年 1 月到 2022 年 3 月，分别对 353 例和 50 例病例进行了开腹和机器人胃十二指肠切除术。经过一对一病例对照配对后，我们比较了机器人PpPD（R-PpPD）和开放式PpPD的临床结果和临床相关DGE的发生率。结果每组各有 30 名患者。R-PpPD术后出现临床相关DGE的情况较少（3/30 [10%] 对 10/30 [33.3%]，P = 0.028）。R-PpPD 组的中位住院时间（LoS）明显缩短（10 天 vs. 15 天，p = 0.013）。结论微创机器人方法减少了组织创伤，降低了 DGE 的发生率，缩短了住院时间，鼓励使用全机器人方法进行 PpPD。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.