Department of General Surgery, Hospital Universitario Marquès de Valdecilla, Santander, Spain,
Department of Emergency and General Surgery, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy,
Dig Surg. 2020;37(3):229-239. doi: 10.1159/000501428. Epub 2019 Jul 3.
Laparoscopic distal pancreatectomy (LDP) has been adopted relatively slowly despite the benefits of minimally invasive approach. The robotic approach can overcome the limitations of LDP, thus increasing the acceptance of minimally invasive distal pancreatectomy.
We performed a 1:1 retrospective case-matched comparison among 2 groups of 35 patients who underwent robotic-assisted distal pancreatectomy (RDP) or LDP from August 2014 to April 2017.
The operative time was similar in both groups (230 RDP vs. 205 LDP min, p = 0.382). The robotic group had a lower estimated blood loss (95 vs. 275 mL, p = 0.035). The spleen preservation rate was higher in the RDP group (100 vs. 66.7%, p = 0.027), while the conversion rate to open surgery was higher in the laparoscopic group (14.3 vs. 2.9%, p = 0.048). The overall complication rate was lower in the robotic group (25.7 vs. 37.1%, p = 0.044). There was no statistically significant difference in oncologic outcomes between the groups in terms of R0 resection rate (100% RDP vs. 85% LDP, p = 0.233) and number of harvested lymph nodes (14.4 RDP vs. 10.8 LDP, p = 0.678).
The RDP showed a lower estimated blood loss, conversion, and morbidity rate. It offered a higher spleen preservation rate in comparison to LDP while maintaining comparable oncologic outcomes.
尽管微创手术具有优势，但腹腔镜胰体尾切除术（LDP）的应用仍相对缓慢。机器人手术可以克服 LDP 的局限性，从而提高微创胰体尾切除术的接受程度。
我们对 2014 年 8 月至 2017 年 4 月间接受机器人辅助胰体尾切除术（RDP）或 LDP 的 35 例患者进行了 1:1 回顾性病例匹配比较。
两组的手术时间相似（RDP 组 230 分钟，LDP 组 205 分钟，p = 0.382）。机器人组估计出血量较少（95 毫升 vs. 275 毫升，p = 0.035）。RDP 组保脾率较高（100% vs. 66.7%，p = 0.027），而腹腔镜组中转开腹率较高（14.3% vs. 2.9%，p = 0.048）。机器人组总体并发症发生率较低（25.7% vs. 37.1%，p = 0.044）。两组在 R0 切除率（RDP 组 100% vs. LDP 组 85%，p = 0.233）和淋巴结清扫数目（RDP 组 14.4 个 vs. LDP 组 10.8 个，p = 0.678）方面的肿瘤学结果无统计学差异。
RDP 术式具有较低的估计出血量、中转开腹率和发病率。与 LDP 相比，它可提供更高的保脾率，同时保持可比的肿瘤学结果。
