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机器人胰头切除术治疗胰腺头部实性假乳头状瘤:来自单中心的倾向评分匹配比较和分析。

Robotic pancreatectomy for solid pseudopapillary tumors in the pancreatic head: A propensity score-matched comparison and analysis from a single center.

机构信息

Pancreatic Disease Center, Department of General Surgery, Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 197 Rui Jin Er Road, Shanghai 200025, PR China.

Pancreatic Disease Center, Department of General Surgery, Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 197 Rui Jin Er Road, Shanghai 200025, PR China.

出版信息

Asian J Surg. 2020 Jan;43(1):354-361. doi: 10.1016/j.asjsur.2019.05.016. Epub 2019 Jul 18.

Abstract

BACKGROUND

Robotic surgery is the most advanced minimally invasive technique for the treatment of complicated solid pseudopapillary tumors (SPT). The aim of this study is to evaluate feasibility of robotic surgery for the treatment of SPTs in the pancreatic head.

METHODS

A retrospective analysis of the clinical data of 83 SPTs in pancreatic head was conducted. Clinical characteristics were extracted and propensity score matching (PSM) was used to compare and evaluate mid-term outcomes of the two techniques.

RESULTS

Pancreaticoduodenectomy (PD), duodenum-preserving partial pancreatic head resection (DPPHR-P) and tumor enucleation (En) were performed in 51, 24, and 8 patients, respectively. The robotic approach was associated with a significantly lower volume of blood loss, lower need for transfusion, and faster time to post-surgery recovery. Major complications and costs were comparable for both techniques.

CONCLUSION

A robotic approach provides an alternative to open surgery for SPTs in the pancreatic head without increasing the incidence of clinically relevant pancreatic fistula (CRPF) or other major complications and with good patient outcomes.

摘要

背景

机器人手术是治疗复杂实性假乳头状瘤(SPT)的最先进的微创技术。本研究旨在评估机器人手术治疗胰头部 SPT 的可行性。

方法

对 83 例胰头部 SPT 的临床资料进行回顾性分析。提取临床特征,并采用倾向评分匹配(PSM)比较两种技术的中期结果。

结果

51 例行胰十二指肠切除术(PD),24 例行保留十二指肠的胰头部分切除术(DPPHR-P),8 例行肿瘤剜除术(En)。机器人手术组的出血量、输血需求和术后恢复时间均显著降低。两种技术的主要并发症和费用相当。

结论

机器人手术为胰头部 SPT 提供了一种替代开放性手术的方法,不会增加临床相关胰瘘(CRPF)或其他主要并发症的发生率,且患者预后良好。

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