Digestive Surgery and Liver Unit, S. Maria Hospital, Via Tristano di Joannuccio n.4, Terni 05100, Italy.
Surg Oncol. 2013 Sep;22(3):201-7. doi: 10.1016/j.suronc.2013.07.002. Epub 2013 Jul 30.
The aim of this systematic review is to determine the potential advantages of robotic distal pancreatectomy (RDP).
Both randomized and non-randomized studies.
Two investigators independently selected studies for inclusion by article abstraction and full text reviewing.
Five non-RCTs were included in the review. The feasibility of RDP (95.4%) and spleen-preserving rate is between 50% and 100%. Mean OT varied between 298 min and 398 min with only completely robotic procedures, whereas mean OT was 293 in "laparoscopic/robotic" technique. Postoperative length of hospital stay ranged from 7 days to 13.7 days. The 30-day postoperative overall morbidity resulted between 0 and 18% of patients.
RDP is an emergent technology for which there are not yet sufficient data to draw definitive conclusions with respect to conventional or laparoscopic surgery. The mean duration of RDP is longer with Da Vinci robot, but hospital stay is shorter even if it is influenced by hospital protocols. We cannot make any conclusions comparing the outcomes to laparoscopic or open procedures here, since none of these studies are randomized, and we all know that most of these surgeons selected the easier cases for robotic procedures. For these reasons randomized controlled trials are recommended to better evaluate RDP cost-effectiveness.
本系统评价旨在确定机器人胰体尾切除术（RDP）的潜在优势。
随机和非随机研究。
两名调查员通过文章摘要和全文审查独立选择纳入的研究。
综述共纳入 5 项非 RCT 研究。RDP 的可行性（95.4%）和保脾率在 50%至 100%之间。完全机器人手术的平均手术时间（OT）在 298 分钟至 398 分钟之间，而“腹腔镜/机器人”技术的平均 OT 为 293 分钟。术后住院时间为 7 天至 13.7 天。30 天术后总发病率在 0%至 18%的患者之间。
RDP 是一项新兴技术，尚无足够数据来对其与传统或腹腔镜手术进行明确的结论。达芬奇机器人辅助的 RDP 平均手术时间较长，但住院时间较短，尽管这可能受到医院方案的影响。我们不能在此处将结果与腹腔镜或开放性手术进行比较，因为这些研究均非随机，而且我们都知道大多数外科医生选择对机器人手术更简单的病例。因此，建议进行随机对照试验以更好地评估 RDP 的成本效益。
