Feng Qingbo, Jiang Chuang, Feng Xuping, Du Yan, Liao Wenwei, Jin Hongyu, Liao Mingheng, Zeng Yong, Huang Jiwei
Department of Liver Surgery and Liver Transplantation Centre, West China Hospital, Sichuan University, Chengdu, China.
Department of Liver Surgery, The First Clinical Medical College of Lanzhou University, Lanzhou, China.
Front Oncol. 2021 Sep 20;11:752236. doi: 10.3389/fonc.2021.752236. eCollection 2021.
Robotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP) are the two principal minimally invasive surgical approaches for patients with pancreatic body and tail adenocarcinoma. The use of RDP and LDP for pancreatic ductal adenocarcinoma (PDAC) remains controversial, and which one can provide a better R0 rate is not clear.
A comprehensive search for studies that compared robotic laparoscopic distal pancreatectomy for PDAC published until July 31, 2021, was conducted. Data on perioperative outcomes and oncologic outcomes (R0-resection and lymph node dissection) were subjected to meta-analysis. PubMed, Cochrane Central Register, Web of Science, and EMBASE were searched based on a defined search strategy to identify eligible studies before July 2021.
Six retrospective studies comprising 572 patients (152 and 420 patients underwent RDP and LDP) were included. The present meta-analysis showed that there were no significant differences in operative time, tumor size, and lymph node dissection between RDP and LDP group. Nevertheless, compared with the LDP group, RDP results seem to demonstrate a possibility in higher R0 resection rate (p<0.0001).
This systematic review and meta-analysis suggest that RDP is a technically and oncologically safe and feasible approach for selected PDAC patients. Large randomized and controlled prospective studies are needed to confirm this data.
https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier [CRD42021269353].
机器人辅助远端胰腺切除术（RDP）和腹腔镜远端胰腺切除术（LDP）是治疗胰体尾腺癌患者的两种主要微创手术方法。RDP和LDP在胰腺导管腺癌（PDAC）中的应用仍存在争议，哪种方法能提供更好的R0切除率尚不清楚。
全面检索截至2021年7月31日发表的比较机器人辅助与腹腔镜远端胰腺切除术治疗PDAC的研究。对围手术期结局和肿瘤学结局（R0切除和淋巴结清扫）的数据进行荟萃分析。根据既定的检索策略，检索了PubMed、Cochrane中心注册库、科学网和EMBASE，以确定2021年7月之前的合格研究。
纳入了6项回顾性研究，共572例患者（152例接受RDP，420例接受LDP）。本荟萃分析表明，RDP组和LDP组在手术时间、肿瘤大小和淋巴结清扫方面无显著差异。然而，与LDP组相比，RDP的结果似乎显示出更高的R0切除率的可能性（p<0.0001）。
本系统评价和荟萃分析表明，RDP对选定的PDAC患者是一种技术上和肿瘤学上安全可行的方法。需要大型随机对照前瞻性研究来证实这些数据。
https://www.crd.york.ac.uk/PROSPERO/#recordDetails，标识符[CRD42021269353]
