Del Chiaro Marco, Segersvärd Ralf
Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Huddinge, K53, 14186 Stockholm, Sweden.
Biomed Res Int. 2014;2014:920492. doi: 10.1155/2014/920492. Epub 2014 May 28.
During the last decades an increasing number of minimally invasive pancreatic resections have been reported in the literature. With the development of robotic surgery a new enthusiasm has not only increased the number of centers approaching minimally invasive pancreatic surgery in general but also enabled the use of this technique for major pancreatic procedures, in particular in minimally invasive pancreatoduodenectomy. The aim of this review was to define the state of the art of pancreatic robotic surgery. No prospective randomized trials have been performed comparing robotic, laparoscopic, and open pancreatic procedures. From the literature one may conclude that robotic pancreatectomies seem to be as feasible and safe as open procedures. The general idea that the overall perioperative costs of robotic surgery would be higher than traditional procedures is not supported. With the current lack of evidence of any oncologic advantages, the cosmetic benefits offered by robotic surgery are not enough to justify extensive use in cancer patients. In contrast, the safety of these procedure can justify the use of the robotic technique in patient with benign/low grade malignant tumors of the pancreas.
在过去几十年里，文献中报道的微创胰腺切除术数量不断增加。随着机器人手术的发展，新的热潮不仅增加了总体上开展微创胰腺手术的中心数量，还使得该技术可用于主要的胰腺手术，特别是在微创胰十二指肠切除术中。本综述的目的是界定胰腺机器人手术的当前技术水平。目前尚未进行比较机器人手术、腹腔镜手术和开放胰腺手术的前瞻性随机试验。从文献中可以得出结论，机器人胰腺切除术似乎与开放手术一样可行且安全。认为机器人手术的总体围手术期成本会高于传统手术的普遍观点缺乏依据。鉴于目前缺乏机器人手术具有任何肿瘤学优势的证据，机器人手术所带来的美容益处不足以证明其在癌症患者中的广泛应用是合理的。相比之下，这些手术的安全性可以证明在患有胰腺良性/低级别恶性肿瘤的患者中使用机器人技术是合理的。
