Guerra F, Pesi B, Amore Bonapasta S, Di Marino M, Perna F, Annecchiarico M, Coratti A
Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy -
Minerva Chir. 2015 Aug;70(4):241-7. Epub 2015 Apr 28.
Over the last decade, robotics has gained popularity and is increasingly employed to accomplish several abdominal surgical procedures. Nevertheless, pancreatectomies are regarded as demanding procedures for which the application of minimally-invasive surgery is still limited and its effectiveness has not been conclusively established. We aimed to investigate the current role of robot-assisted surgery to perform distal pancreatectomy. A systematic review of the English-language literature was conducted for articles dealing with robotic-assisted distal pancreatectomies. All relevant papers were evaluated on surgical and oncological outcomes. A total of 10 articles reporting on robotic distal pancreatectomies were finally considered in the analysis, including 259 patients. Mean operative time was 271 minutes (range 181-398); mean blood loss was 210 mL (range 104-361), in 11.6% of cases conversion to laparotomy occurred, spleen preservation was accomplished in 51.4% of procedures, mean time of postoperative hospital stay was 7 days. Overall, postoperative mortality and morbidity were 0% and 23.4% respectively, the mean number of lymph nodes harvested was 12.7. In all included series, no case of R1 resection was reported. Despite its relatively recent introduction in clinical practice, robotic-assisted surgery has been widely employed to perform distal pancreatectomy worldwide and it should be considered a safe and effective procedure. Both surgical and pathologic data support its application in the management of pancreatic lesions of the body and tail.
在过去十年中，机器人技术越来越受欢迎，并越来越多地用于完成多种腹部外科手术。然而，胰腺切除术被认为是具有挑战性的手术，微创手术在其中的应用仍然有限，其有效性尚未得到最终证实。我们旨在研究机器人辅助手术在进行远端胰腺切除术中的当前作用。我们对英文文献进行了系统回顾，以查找有关机器人辅助远端胰腺切除术的文章。所有相关论文均根据手术和肿瘤学结果进行评估。最终，分析中纳入了10篇关于机器人远端胰腺切除术的报告，共259例患者。平均手术时间为271分钟（范围181 - 398分钟）；平均失血量为210毫升（范围104 - 361毫升），11.6%的病例中转开腹，51.4%的手术中实现了脾脏保留，术后平均住院时间为7天。总体而言，术后死亡率和发病率分别为0%和23.4%，平均获取的淋巴结数量为12.7个。在所有纳入的系列研究中，均未报告R1切除病例。尽管机器人辅助手术在临床实践中引入的时间相对较晚，但它已在全球范围内广泛用于进行远端胰腺切除术，应被视为一种安全有效的手术。手术和病理数据均支持其在处理胰体尾病变中的应用。
