Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Transpl Int. 2019 Nov;32(11):1173-1181. doi: 10.1111/tri.13477. Epub 2019 Aug 1.
The prevalence of obesity within the diabetic population is on the rise. This development poses unique challenges for pancreas transplantation candidates as obese individuals are often denied access to transplant. The introduction of robotic approach to transplant has been shown to improve outcomes in obese patients. A single center retrospective review of pancreas transplant cases over a 4-year period ending December 2018 was performed. Patients undergoing robotic surgery were compared to their counterparts undergoing open transplant. 49 patients (10 robot, 39 open) received pancreas transplants over the study period. Mean age was 43.1 ± 7.5 vs. 42.8 ± 9.7 years. There were no significant differences in demographics except body mass index (33.7 ± 5.2 vs. 27.1 ± 6.6, P = 0.005). Operative duration (7.6 ± 1.6 vs. 5.3 ± 1.4, P < 0.001), and warm ischemia times [45.5 (IQR: 13.7) vs. 33 (7), P < 0.001] were longer in the robotic arm. There were no wound complications in the robotic approach patients. Graft (100% vs. 88%, P = 0.37) and patient survival (100% vs. 100%, P = 0.72) after 1 year were similar. Our findings suggest that robotic pancreas is both safe and effective in obese diabetic patients, without added risk of wound complications. Wide adoption of the technique is encouraged while long term follow-up of our recipients is awaited.
糖尿病患者中的肥胖患病率呈上升趋势。这一发展对胰腺移植候选人构成了独特的挑战，因为肥胖患者通常被拒绝接受移植。机器人辅助移植方法的引入已被证明可改善肥胖患者的结局。对 2018 年 12 月结束的 4 年期间的胰腺移植病例进行了单中心回顾性研究。将接受机器人手术的患者与接受开放移植的患者进行了比较。研究期间共有 49 名患者（10 例机器人手术，39 例开放手术）接受了胰腺移植。平均年龄为 43.1±7.5 岁比 42.8±9.7 岁。除体重指数（33.7±5.2 比 27.1±6.6，P=0.005）外，两组患者在人口统计学方面无显著差异。手术时间（7.6±1.6 比 5.3±1.4，P<0.001）和热缺血时间[45.5（IQR：13.7）比 33（7），P<0.001]在机器人组中更长。机器人组患者无手术切口并发症。1 年后，移植物（100%比 88%，P=0.37）和患者存活率（100%比 100%，P=0.72）相似。我们的研究结果表明，机器人胰腺在肥胖的糖尿病患者中既安全又有效，不会增加手术切口并发症的风险。鼓励广泛采用该技术，同时等待我们的受者进行长期随访。
