Ielpo Benedetto, Caruso Riccardo, Duran Hipolito, Diaz Eduardo, Fabra Isabel, Malavé Luis, Quijano Yolanda, Vicente Emilio
General Surgery Department, Sanchinarro University Hospital, San Pablo CEU University of Madrid, Calle Oña 10, 28050, Madrid, Spain.
Updates Surg. 2019 Mar;71(1):137-144. doi: 10.1007/s13304-018-0529-1. Epub 2018 Mar 26.
Interest in robotic pancreatectomy has been greatly increasing over the last decade. However, evidence supporting the benefits of robotic over open pancreatectomy is still outstanding. This study aims to assess the safety and efficacy of robotic pancreatectomy compared with the conventional open surgical approach. Propensity score-matched (1:1) was used to balance age, sex, BMI, ASA, tumor size, and malignancy of 17 robotic pancreaticoduodenectomies (PD), 12 pancreatic enucleations (PE), and 28 distal pancreatectomies (DP); and was compared with the open standard approach. Robotic PD was associated with longer operative time (594 vs. 413 min; p = 0.03) and decreased blood loss (190 vs. 394 ml; p = 0.001). Robotic PE showed a lower mean length of hospital stay (8.4 vs. 12.8 days; p = 0.04) and, in addition, robotic DP showed less blood loss (175 vs. 375 ml; p = 0.01), less severe morbidities (7.14 vs. 17.9%; p = 0.02), and a reduced mean length of hospital stay (8.9 vs. 15.1; p = 0.001). Overall, conversion rate was 4 (7%). Robotic pancreatectomy is as safe and effective as the standard open surgical approach with reduced blood loss in PD and DP, length of hospital stay in PE and DP, and severe morbidity in DP.
在过去十年中,对机器人胰腺切除术的兴趣大幅增加。然而,支持机器人胰腺切除术优于开放胰腺切除术的证据仍不充分。本研究旨在评估机器人胰腺切除术与传统开放手术方法相比的安全性和有效性。采用倾向评分匹配法(1:1)对17例机器人胰十二指肠切除术(PD)、12例胰腺摘除术(PE)和28例远端胰腺切除术(DP)的年龄、性别、体重指数、美国麻醉医师协会分级、肿瘤大小和恶性程度进行平衡,并与开放标准方法进行比较。机器人PD手术时间较长(594 vs. 413分钟;p = 0.03),失血量减少(190 vs. 394毫升;p = 0.001)。机器人PE的平均住院时间较短(8.4 vs. 12.8天;p = 0.04),此外,机器人DP的失血量较少(175 vs. 375毫升;p = 0.01),严重并发症较少(7.14% vs. 17.9%;p = 0.02),平均住院时间缩短(8.9 vs. 15.1天;p = 0.001)。总体而言,中转率为4例(7%)。机器人胰腺切除术与标准开放手术方法一样安全有效,在PD和DP中减少了失血量,在PE和DP中缩短了住院时间,在DP中降低了严重并发症的发生率。