Teo Roxanne Y A, Goh Brian K P
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.
Duke-National University of Singapore Medical School, Singapore.
Gland Surg. 2018 Feb;7(1):1-11. doi: 10.21037/gs.2017.10.06.
Over the past decade, there has been increasing adoption of minimally invasive pancreatic surgery world-wide and this has naturally expanded to the management of pancreatic neuroendocrine neoplasms (PNENs). More recently, robotic pancreatic surgery (RPS) was introduced to overcome the limitations during laparoscopic pancreatic surgery (LPS). Due to the relative rarity of PNEN and the novelty of minimally invasive pancreatic surgery in particular RPS today, the evidence for robotic surgery in PNENs remains extremely limited. Presently, the available evidence is limited to a few low level retrospective case-control studies. These studies suggest that RPS may be associated with a higher splenic preservation rates and lower open conversion rates compared to conventional laparoscopic surgery. Ideally a prospective randomized trial should be performed but this would be extremely challenging due to the rarity of PNEN, making it almost impossible to conduct a sufficiently powered trial.
在过去十年中，全球范围内越来越多地采用微创胰腺手术，这自然也扩展到了胰腺神经内分泌肿瘤（PNENs）的治疗。最近，引入了机器人胰腺手术（RPS）以克服腹腔镜胰腺手术（LPS）中的局限性。由于PNEN相对罕见，尤其是微创胰腺手术（特别是RPS）尚属新颖，目前关于机器人手术治疗PNENs的证据仍然极为有限。目前，现有的证据仅限于少数低水平的回顾性病例对照研究。这些研究表明，与传统腹腔镜手术相比，RPS可能具有更高的脾脏保留率和更低的中转开腹率。理想情况下，应该进行一项前瞻性随机试验，但由于PNEN罕见，这极具挑战性，几乎不可能进行一项样本量足够大的试验。
