Robotic versus laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma: A propensity score-matched analysis

作     者：Dakyum Shin Jaewoo Kwon Jae Hoon Lee Seo Young Park Yejong Park Woohyung Lee Ki Byung Song Dae Wook Hwang Song Cheol Kim Dakyum Shin;Jaewoo Kwon;Jae Hoon Lee;Seo Young Park;Yejong Park;Woohyung Lee;Ki Byung Song;Dae Wook Hwang;Song Cheol Kim

作者机构：Division of Hepato-Biliary and Pancreatic SurgeryDepartment of SurgeryAsan Medical CenterUniversity of Ulsan College of Medicine88 Olympic-ro 43-gilSongpa-guSeoul 05505Korea Department of SurgeryKangbuk Samsung HospitalSungkyunkwan University School of Medicine29 Saemunan-roJongno-guSeoul 03181Korea Department of Statistics and Data ScienceKorea National Open University86 Daehak-roJongno-guSeoul 03087Korea 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2023年第22卷第2期

页      面：154-159页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Minimally invasive surgery Robotic distal pancreatectomy Laparoscopic distal pancreatectomy Pancreatic ductal adenocarcinoma Propensity score matching 

摘      要：Background: Minimally invasive surgery is becoming increasingly popular in the field of pancreatic surgery. However, there are few studies of robotic distal pancreatectomy(RDP) for pancreatic ductal adenocarcinoma(PDAC). This study aimed to investigate the efficacy and feasibility of RDP for PDAC. Methods: Patients who underwent RDP or laparoscopic distal pancreatectomy(LDP) for PDAC between January 2015 and September 2020 were reviewed. Propensity score matching analyses were performed. Results: Of the 335 patients included in the study, 24 underwent RDP and 311 underwent LDP. A total of 21 RDP patients were matched 1:1 with LDP patients. RDP was associated with longer operative time(209.7 vs. 163.2 min;P = 0.003), lower open conversion rate(0% vs. 4.8%;P 0.001), higher cost(15 722 vs. 12 699 dollars;P = 0.003), and a higher rate of achievement of an R0 resection margin(90.5% vs. 61.9%;P = 0.042). However, postoperative pancreatic fistula grade B or C showed no significant intergroup difference(9.5% vs. 9.5%). The median disease-free survival(34.5 vs. 17.3 months;P = 0.588) and overall survival(37.7 vs. 21.9 months;P = 0.171) were comparable between the groups. Conclusions: RDP is associated with longer operative time, a higher cost of surgery, and a higher likelihood of achieving R0 margins than LDP.