Huang Jyun-Ming, Chen Sheng-Hsien, Chen Te-Hung
Department of Surgery, China Medical University Hospital, No. 2, Yude Rd., North Dist., Taichung City 404327, Taiwan.
School of Medicine, China Medical University, No. 2, Yude Rd., North Dist., Taichung City 404, Taiwan.
Cancers (Basel). 2024 Feb 29;16(5):1003. doi: 10.3390/cancers16051003.
The primary treatment for pancreatic cancer is surgical resection, and laparoscopic resection offers benefits over open surgery. This study aimed to compare the short-term outcomes of robot-assisted vs. conventional laparoscopic distal pancreatectomy.
Data of adults ≥ 20 years old with pancreatic cancer who underwent conventional laparoscopic or robot-assisted laparoscopic distal pancreatectomy were extracted from the United States (US) Nationwide Inpatient Sample (NIS) 2005-2018 database. Comorbidities and complications were identified through the International Classification of Diseases (ICD) codes. Short-term outcomes were compared using logistic regression and included length of hospital stay (LOS), perioperative complications, in-hospital mortality, unfavorable discharge, and total hospital costs.
A total of 886 patients were included; 27% received robot-assisted, and 73% received conventional laparoscopic surgery. The mean age of all patients was 65.3 years, and 52% were females. Multivariable analysis revealed that robot-assisted surgery was associated with a significantly reduced risk of perioperative complications (adjusted odds ratio (aOR) = 0.61, 95% confidence interval (CI): 0.45-0.83) compared to conventional laparoscopic surgery. Specifically, robot-assisted surgery was associated with a significantly decreased risk of VTE (aOR = 0.35, 95% CI: 0.14-0.83) and postoperative blood transfusion (aOR = 0.37, 95% CI: 0.23-0.61). Robot-assisted surgery was associated with a significantly shorter LOS (0.76 days shorter, 95% CI: -1.43--0.09) but greater total hospital costs (18,284 USD greater, 95% CI: 4369.03-32,200.70) than conventional laparoscopic surgery.
Despite the higher costs, robot-assisted distal pancreatectomy is associated with decreased risk of complications and shorter hospital stays than conventional laparoscopic distal pancreatectomy.
胰腺癌的主要治疗方法是手术切除，与开放手术相比，腹腔镜切除术具有诸多优势。本研究旨在比较机器人辅助与传统腹腔镜远端胰腺切除术的短期疗效。
从美国2005 - 2018年全国住院患者样本（NIS）数据库中提取年龄≥20岁、接受传统腹腔镜或机器人辅助腹腔镜远端胰腺切除术的胰腺癌成年患者数据。通过国际疾病分类（ICD）编码确定合并症和并发症。使用逻辑回归比较短期疗效，包括住院时间（LOS）、围手术期并发症、院内死亡率、不良出院情况及总住院费用。
共纳入886例患者；27%接受机器人辅助手术，73%接受传统腹腔镜手术。所有患者的平均年龄为65.3岁，52%为女性。多变量分析显示，与传统腹腔镜手术相比，机器人辅助手术围手术期并发症风险显著降低（调整优势比（aOR）=0.61，95%置信区间（CI）：0.45 - 0.83）。具体而言，机器人辅助手术发生静脉血栓栓塞（VTE）风险显著降低（aOR = 0.35，95% CI：0.14 - 0.83），术后输血风险显著降低（aOR = 0.37，95% CI：0.23 - 0.61）。与传统腹腔镜手术相比，机器人辅助手术的住院时间显著缩短（短0.76天，95% CI： - 1.43 - -
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