Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China.
Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Surg Endosc. 2022 Dec;36(12):9186-9193. doi: 10.1007/s00464-022-09402-8. Epub 2022 Jul 18.
Robotic surgery is the most recent advanced minimally invasive approach for distal pancreatectomy. However, its benefits over laparoscopic distal pancreatectomy (LDP) remain undetermined. Previous studies were limited by their small sample size or variations in surgeon skills. This study aimed to compare robotic distal pancreatectomy (RDP) performed by a single surgeon with LDP performed by skilled laparoscopic surgeons in a high-volume center.
We retrospectively analyzed consecutive RDP performed by a single surgeon between December 2020 and November 2021 with LDP performed by experienced surgeons during the same period in a high-volume center. Patient characteristics and perioperative variables were compared.
The analysis included 55 RDP and 146 LDP procedures. The operative time in the RDP group was significantly shorter than the LDP group (171 vs. 222 min, P < 0.001), both in spleen-preserved (154 vs. 212 min, P < 0.001) and spleen-removed (192 vs. 230 min, P = 0.005) procedures. The RDP group made more frequent use of the stapler technique for pancreas transection (87.3 vs. 68.5%, P = 0.007), and its estimated blood loss was lower (79 vs. 155 mL, P < 0.001) than the LDP group. The postoperative hospital stay in the RDP group was significantly shorter than the LDP group (8 vs. 12 days, P < 0.001). The groups were similar in their complication distributions.
RDP is as safe and feasible a minimally invasive approach as LDP. The advanced manipulation and visualization capabilities of the robotic approach in distal pancreatectomy could help reduce operative time and blood loss, and is related to shorter postoperative hospital stay.
机器人手术是远端胰腺切除术的最新微创先进方法。然而，它相对于腹腔镜下远端胰腺切除术（LDP）的优势仍未确定。以前的研究受到样本量小或外科医生技能差异的限制。本研究旨在比较由一位外科医生进行的机器人远端胰腺切除术（RDP）与高容量中心经验丰富的腹腔镜外科医生进行的 LDP。
我们回顾性分析了 2020 年 12 月至 2021 年 11 月期间由一位外科医生进行的连续 RDP 与同期高容量中心经验丰富的外科医生进行的 LDP。比较了患者特征和围手术期变量。
分析包括 55 例 RDP 和 146 例 LDP 手术。RDP 组的手术时间明显短于 LDP 组（171 分钟比 222 分钟，P < 0.001），在保留脾脏（154 分钟比 212 分钟，P < 0.001）和切除脾脏（192 分钟比 230 分钟，P = 0.005）手术中均如此。RDP 组更频繁地使用吻合器技术进行胰腺横断（87.3%比 68.5%，P = 0.007），其估计出血量也较低（79 毫升比 155 毫升，P < 0.001）。RDP 组的术后住院时间明显短于 LDP 组（8 天比 12 天，P < 0.001）。两组的并发症分布相似。
RDP 是一种与 LDP 一样安全可行的微创方法。机器人在远端胰腺切除术中的先进操作和可视化能力有助于减少手术时间和出血量，并与较短的术后住院时间相关。
