Department of Surgical Oncology, Florida Hospital Orlando, Orlando.
Department of Surgical Oncology, Florida Hospital Orlando, Orlando2Department of Surgery, University of Central Florida, Orlando.
JAMA Surg. 2013 Dec;148(12):1154-7. doi: 10.1001/jamasurg.2013.366.
Over the past decade, minimally invasive surgery has been introduced as a means to allow manipulation of delicate tissues with outstanding visualization of the surgical field. The purpose of this article is to review the available literature regarding early postoperative outcomes and the technical challenges of minimally invasive pancreaticoduodenectomy, including robotic techniques. Herein, we provide a retrospective review of all published studies in the English literature in which a minimally invasive pancreaticoduodenectomy was performed. The reported advantages of minimally invasive pancreaticoduodenectomy include better visualization, faster recovery time, and decreased length of hospital stay. In cases of robotic approaches, some of the proposed advantages include increased dexterity and a superior ergonomic position for the operating surgeon. To our knowledge, few studies have reported results comparable to open techniques in oncologic outcomes with regard to the number of lymph nodes resected and clear margins obtained. An increasing number of pancreatic resections are being performed using minimally invasive approaches. It remains to be determined if the benefits of this technique outweigh its longer operative times and higher costs.
在过去的十年中，微创外科已被引入，以允许精细组织的操作，并提供出色的手术视野。本文的目的是回顾微创胰十二指肠切除术（包括机器人技术）的现有文献，以了解其早期术后结果和技术挑战。本文对所有在英文文献中发表的微创胰十二指肠切除术的研究进行了回顾性分析。微创胰十二指肠切除术的报道优势包括更好的可视化、更快的恢复时间和缩短住院时间。在机器人方法的情况下，一些提出的优势包括增加的灵巧性和手术医生更优越的符合人体工程学的操作位置。据我们所知，很少有研究报告在淋巴结切除数量和获得清晰切缘方面的肿瘤学结果与开放技术可比。越来越多的胰腺切除术采用微创方法进行。尚不确定该技术的优势是否超过其较长的手术时间和更高的成本。
