{"title":"胰腺腺癌微创远端胰腺切除术:关于手术效果和医疗保健差异的倾向匹配全国性分析","authors":"","doi":"10.1016/j.amjsurg.2024.115897","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Pancreatic adenocarcinoma of distal pancreas is hard to treat due to late presentation. While open distal pancreatectomy with splenectomy has had favourable outcomes, it has also had many complications which were low among Minimally invasive procedures. This retrospective cohort analysis compares minimally invasive and open distal pancreatectomy (MIDP) outcomes using a national inpatient database.</p></div><div><h3>Methods</h3><p>The study used 2016–2020 NIS data. The study included 1577 distal pancreatic malignant tumor surgery patients. There were 530 Minimally Invasive and 1047 Open groups. Propensity matched analysis was performed on surgical groups to reduce confounding variables.</p></div><div><h3>Results</h3><p>In comparison to open procedures, minimally invasive techniques reduced hospital stays by 10 % (OR = 0.90, 95 % CI 0.86–0.93). While not statistically significant, the unmatched analysis linked MIDP to lower in-hospital mortality. African Americans were 37 % less likely to undergo MIDP than Caucasians (OR = 0.63, 95 % CI = 0.40–0.96).</p></div><div><h3>Conclusion</h3><p>Nationwide analysis suggests MIDP may be a safe and effective surgical treatment for distal pancreatic adenocarcinoma. It may reduce hospital stays and mortality over open surgery. The study also suggests race may affect minimally invasive procedure rates.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Minimally invasive distal pancreatectomy for pancreatic adenocarcinoma: A propensity-matched national analysis on surgical outcomes and healthcare disparities\",\"authors\":\"\",\"doi\":\"10.1016/j.amjsurg.2024.115897\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Pancreatic adenocarcinoma of distal pancreas is hard to treat due to late presentation. While open distal pancreatectomy with splenectomy has had favourable outcomes, it has also had many complications which were low among Minimally invasive procedures. This retrospective cohort analysis compares minimally invasive and open distal pancreatectomy (MIDP) outcomes using a national inpatient database.</p></div><div><h3>Methods</h3><p>The study used 2016–2020 NIS data. The study included 1577 distal pancreatic malignant tumor surgery patients. There were 530 Minimally Invasive and 1047 Open groups. Propensity matched analysis was performed on surgical groups to reduce confounding variables.</p></div><div><h3>Results</h3><p>In comparison to open procedures, minimally invasive techniques reduced hospital stays by 10 % (OR = 0.90, 95 % CI 0.86–0.93). While not statistically significant, the unmatched analysis linked MIDP to lower in-hospital mortality. African Americans were 37 % less likely to undergo MIDP than Caucasians (OR = 0.63, 95 % CI = 0.40–0.96).</p></div><div><h3>Conclusion</h3><p>Nationwide analysis suggests MIDP may be a safe and effective surgical treatment for distal pancreatic adenocarcinoma. It may reduce hospital stays and mortality over open surgery. The study also suggests race may affect minimally invasive procedure rates.</p></div>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-08-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0002961024004495\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002961024004495","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景胰腺远端腺癌因发病较晚而难以治疗。虽然开腹远端胰腺切除术和脾切除术取得了良好的疗效,但也出现了许多并发症,而微创手术的并发症较少。这项回顾性队列分析利用全国住院患者数据库,比较了微创和开放式远端胰腺切除术(MIDP)的疗效。研究纳入了1577名远端胰腺恶性肿瘤手术患者。其中微创组530例,开放组1047例。对手术组进行倾向匹配分析,以减少混杂变量。结果与开放手术相比,微创技术缩短了10%的住院时间(OR = 0.90,95 % CI 0.86-0.93)。虽然没有统计学意义,但非匹配分析将微创手术与较低的院内死亡率联系在一起。非裔美国人接受 MIDP 的可能性比白种人低 37%(OR = 0.63,95 % CI = 0.40-0.96)。与开腹手术相比,它可以缩短住院时间,降低死亡率。研究还表明,种族可能会影响微创手术率。
Minimally invasive distal pancreatectomy for pancreatic adenocarcinoma: A propensity-matched national analysis on surgical outcomes and healthcare disparities
Background
Pancreatic adenocarcinoma of distal pancreas is hard to treat due to late presentation. While open distal pancreatectomy with splenectomy has had favourable outcomes, it has also had many complications which were low among Minimally invasive procedures. This retrospective cohort analysis compares minimally invasive and open distal pancreatectomy (MIDP) outcomes using a national inpatient database.
Methods
The study used 2016–2020 NIS data. The study included 1577 distal pancreatic malignant tumor surgery patients. There were 530 Minimally Invasive and 1047 Open groups. Propensity matched analysis was performed on surgical groups to reduce confounding variables.
Results
In comparison to open procedures, minimally invasive techniques reduced hospital stays by 10 % (OR = 0.90, 95 % CI 0.86–0.93). While not statistically significant, the unmatched analysis linked MIDP to lower in-hospital mortality. African Americans were 37 % less likely to undergo MIDP than Caucasians (OR = 0.63, 95 % CI = 0.40–0.96).
Conclusion
Nationwide analysis suggests MIDP may be a safe and effective surgical treatment for distal pancreatic adenocarcinoma. It may reduce hospital stays and mortality over open surgery. The study also suggests race may affect minimally invasive procedure rates.
期刊介绍:
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.