Jiang Yabo, Zheng Kailian, Zhang Shichao, Shao Zhuo, Cheng Peng, Zhang Yijie, Jin Gang, He Tianlin
Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Department of Pancreatic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Transl Cancer Res. 2020 Sep;9(9):5166-5172. doi: 10.21037/tcr-19-2121.
The aim of this retrospective study was to compare robot-assisted distal pancreatectomy (RDP) with laparoscopic distal pancreatectomy (LDP) for patients with benign and low-grade malignant lesions of the pancreas.
This study included 166 patients who underwent RDP (n=63) or LDP (n=103) for benign or low-grade malignant lesions of the pancreas from January 2011 to October 2018 in Changhai Hospital. A retrospective analysis was performed between the two groups. The primary points were operation time, operative blood loss, hospital stay, pancreatic fistula and spleen preservation.
There were no significant differences in patient characteristics or indications between RDP and LDP. Notably, among all patients, RDP was associated with a significantly higher rate of spleen preservation than that for LDP (30.2% 6.8%, P<0.001), while other intraoperative variables were similar between the two groups. No death cases in the study group within 30 days were reported in either group. Referring to postoperative outcomes, postoperative pancreatic fistula (POPF) was 22% for the RDP group and 33% for the LDP group. In addition, the rate of clinically significant grade B/C pancreatic fistula was 5% and 7%, respectively. There were also no significant differences in hospital stay (6.0±3.0 6.4±2.5, P=0.404). Furthermore, the univariate analysis demonstrated that tumor size (P=0.001) and surgery group (RDP/LDP) (P=0.002) were associated with SP rate independent factor for spleen preservation.
RDP is an effective and safe technique with significant advantage in spleen preservation for patients with benign and low-grade malignant lesions in the distal pancreas.
本回顾性研究旨在比较机器人辅助远端胰腺切除术（RDP）与腹腔镜远端胰腺切除术（LDP）治疗胰腺良性和低度恶性病变患者的效果。
本研究纳入了2011年1月至2018年10月在长海医院因胰腺良性或低度恶性病变接受RDP（n = 63）或LDP（n = 103）的166例患者。对两组进行回顾性分析。主要观察指标为手术时间、术中出血量、住院时间、胰瘘和脾脏保留情况。
RDP组和LDP组患者的特征及适应证无显著差异。值得注意的是，在所有患者中，RDP组的脾脏保留率显著高于LDP组（30.2%对6.8%，P < 0.001），而两组间其他术中变量相似。两组均未报告研究组30天内死亡病例。关于术后结果，RDP组术后胰瘘（POPF）发生率为22%，LDP组为33%。此外，临床显著的B/C级胰瘘发生率分别为5%和7%。住院时间也无显著差异（6.0±3.0对6.4±2.5，P = 0.404）。此外，单因素分析表明肿瘤大小（P = 0.001）和手术组（RDP/LDP）（P = 0.002）是与脾脏保留率相关的独立因素。
对于远端胰腺良性和低度恶性病变患者，RDP是一种有效且安全的技术，在脾脏保留方面具有显著优势。
