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胰腺癌微创左半胰切除术的手术及肿瘤学结果:机器人手术与腹腔镜手术方法对比

Surgical and Oncological Outcomes of Minimally Invasive Left Pancreatectomy for Pancreatic Cancer: Robotic vs. Laparoscopic Approach.

作者信息

De Pastena Matteo, Lionetto Gabriella, Paiella Salvatore, Maruccio Martina, Faustini Federico, Venturini Elisa, Pea Antonio, Casciani Fabio, Malleo Giuseppe, Esposito Alessandro

机构信息

Pancreatic Surgery Unit, University of Verona Hospital Trust, 37129 Verona, Italy.

University of Verona, 37129 Verona, Italy.

出版信息

Curr Oncol. 2025 Jun 28;32(7):376. doi: 10.3390/curroncol32070376.

Abstract

OBJECTIVE

This study compares the surgical and oncological outcomes of minimally invasive robotic (RLP) and laparoscopic (LLP) left pancreatectomy in pancreatic cancer (PC) patients.

METHODS

Data from patients who underwent minimally invasive left pancreatectomy between 2013 and 2023 were analyzed. Two groups were identified: RLP and LLP. Perioperative outcomes were compared, including operative time, blood loss, conversion rate, and postoperative complications. Oncological outcomes included margin status, lymph node retrieval, lymph node status, overall survival (OS), and disease-free survival (DFS).

RESULTS

Fifty-four patients were divided into the LLP ( = 39) and RLP ( = 15) groups. The median operative time was shorter for LLP than RLP [260 min vs. 366 min, = 0.007]. Blood loss and conversion rates were comparable ( > 0.05). In the LLP group, significantly more lymph nodes were harvested (29 vs. 19, = 0.05), and a higher percentage of positive lymph nodes was noted (72% vs. 40%, = 0.033). No significant difference was found in the R0 resection status (82% vs. 73%, = 0.358). After a median follow-up of 26 months, OS (23 months vs. 34 months, = 0.812) and DFS (17 months vs. 16 months, = 0.635) were similar.

CONCLUSION

RLP provides outcomes identical to LLP in treating body-tail pancreatic cancer, with further studies needed to confirm its long-term oncological efficacy.

摘要

目的

本研究比较了胰腺癌(PC)患者行微创机器人左胰切除术(RLP)和腹腔镜左胰切除术(LLP)的手术及肿瘤学结局。

方法

分析2013年至2023年间接受微创左胰切除术患者的数据。分为两组:RLP组和LLP组。比较围手术期结局,包括手术时间、失血量、中转率和术后并发症。肿瘤学结局包括切缘状态、淋巴结清扫数量、淋巴结状态、总生存期(OS)和无病生存期(DFS)。

结果

54例患者分为LLP组(n = 39)和RLP组(n = 15)。LLP组的中位手术时间短于RLP组[260分钟对366分钟,P = 0.007]。失血量和中转率相当(P>0.05)。LLP组清扫的淋巴结明显更多(29枚对19枚,P = 0.05),阳性淋巴结百分比更高(72%对40%,P = 0.033)。R0切除状态无显著差异(82%对73%,P = 0.358)。中位随访26个月后,OS(23个月对34个月,P = 0.812)和DFS(17个月对16个月,P = 0.635)相似。

结论

RLP在治疗胰体尾癌方面的结局与LLP相同,其长期肿瘤学疗效有待进一步研究证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f3b/12293756/1bf16df2d956/curroncol-32-00376-g001.jpg

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