Robotic versus laparoscopic distal pancreatectomy for pancreatic adenocarcinoma in obese patients

IF 2.3 3区医学 Q2 SURGERY International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2023-11-08 DOI:10.1002/rcs.2596

Fabio Ausania, Filippo Landi, Carolina González-Abós, John B. Martinie, Dionisios Vrochides, Matthew Walsh, Shanaz M. Hossain, Steven White, Viswakumar Prabakaran, Laleh G. Melstrom, Yuman Fong, Valentina Valle, Yuntao Bing, Dianrong Xiu, Gregorio Di Franco, Nicola de' Angelis, Alexis Laurent, Giuseppe Giuliani, Graziano Pernazza, Riccardo Memeo, José Rios, Andrea Coratti, Luca Morelli, Pier C. Giulianotti

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Abstract

Background

Robotic distal pancreatectomy (RDP) is associated with a lower conversion rate and less blood loss than laparoscopic distal pancreatectomy (LDP). LDP has similar oncological outcomes as open surgery in PDAC. The aim of this study was to compare perioperative and oncological outcomes in obese patients with RDP versus LDP for PDAC.

Materials and methods

Retrospectively, all obese patients who underwent RDP or LDP for PDAC between 2012 and 2022 at 12 international expert centres were included.

Results

out of 372, 81 patients were included. All baseline features were comparable between the two groups. RDP was associated with decreased blood loss (495mlLDP vs. 188mlRDP; p = 0.003), lower conversion rate (13.5%RDP vs. 36.4%LDP; p = 0.019) and lower rate of Clavien-Dindo ≥3 complications (13.5%RDP vs. 36.4%LDP; p = 0.019). Overall and disease-free survival were comparable.

Conclusions

In obese patients with left-sided PDAC, the robotic approach was associated with improved intraoperative outcomes and fewer severe complications.

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机器人与腹腔镜胰腺癌远端切除术治疗肥胖患者的胰腺癌。

背景：与腹腔镜胰远端切除术（LDP）相比，机器人胰远端切除手术（RDP）具有更低的转化率和更少的失血。LDP与PDAC的开放手术具有相似的肿瘤学结果。本研究的目的是比较RDP和LDP治疗PDAC的肥胖患者的围手术期和肿瘤学结果。材料和方法：回顾性地，纳入2012年至2022年间在12个国际专家中心接受RDP或LDP治疗的所有肥胖患者。结果：372例患者中，81例被纳入。两组之间的所有基线特征具有可比性。RDP与失血减少（495mlLDP对188mlRDP；p=0.003）、转化率降低（13.5%RDP对36.4%LDP；p=0.019。结论：在患有左侧PDAC的肥胖患者中，机器人入路可改善术中结果，减少严重并发症。

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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.