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A retrospective comparison of robotic versus laparoscopic distal resection and enucleation for potentially benign pancreatic neoplasms.
Surg Today. 2020 Aug; 50(8):872-880.ST

Abstract

PURPOSE

The present study aimed to compare robotic-assisted versus laparoscopic distal pancreatic resection and enucleation for potentially benign pancreatic neoplasms.

METHODS

Patients were retrieved from a prospectively maintained database. Demographic data, tumor types, and the perioperative outcomes were retrospectively analyzed.

RESULTS

In a 10-year period, 75 patients (female, n = 44; male, n = 31; median age, 53 years [range, 9-84 years]) were identified. The majority of patients had pancreatic neuroendocrine neoplasms (n = 39, 52%) and cystic neoplasms (n = 23, 31%) with a median tumor size of 17 (3-60) mm. Nineteen (25.3%) patients underwent enucleation (robotic, n = 11; laparoscopic, n = 8) and 56 (74.7%) patients underwent distal pancreatic resection (robotic, n = 24; laparoscopic, n = 32), of those 48 (85%) underwent spleen-preserving procedures. Eight (10.7%) procedures had to be converted to open surgery. The rate of vessel preservation in distal pancreatectomy was significantly higher in robotic-assisted procedures (62.5% vs. 12.5%, p = 0.01). Twenty-six (34.6%) patients experienced postoperative complications (Clavien-Dindo grade > 3). Twenty (26.7%) patients developed a pancreatic fistula type B. There was no mortality. After a median follow-up period of 58 months (range 2-120 months), one patient (1.3%) developed local recurrence (glucagonoma) after enucleation, which was treated with a Whipple procedure.

CONCLUSION

The robotic approach is comparably safe, but increases the rate of splenic vessel preservation and reduces the risk of conversion to open surgery.

Authors+Show Affiliations

Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstrasse, 35043, Marburg, Germany. nawid.najafi@uk-gm.de.Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstrasse, 35043, Marburg, Germany.Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstrasse, 35043, Marburg, Germany.Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstrasse, 35043, Marburg, Germany.Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstrasse, 35043, Marburg, Germany.Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstrasse, 35043, Marburg, Germany.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

32016613

Citation

Najafi, Nawid, et al. "A Retrospective Comparison of Robotic Versus Laparoscopic Distal Resection and Enucleation for Potentially Benign Pancreatic Neoplasms." Surgery Today, vol. 50, no. 8, 2020, pp. 872-880.
Najafi N, Mintziras I, Wiese D, et al. A retrospective comparison of robotic versus laparoscopic distal resection and enucleation for potentially benign pancreatic neoplasms. Surg Today. 2020;50(8):872-880.
Najafi, N., Mintziras, I., Wiese, D., Albers, M. B., Maurer, E., & Bartsch, D. K. (2020). A retrospective comparison of robotic versus laparoscopic distal resection and enucleation for potentially benign pancreatic neoplasms. Surgery Today, 50(8), 872-880. https://doi.org/10.1007/s00595-020-01966-z
Najafi N, et al. A Retrospective Comparison of Robotic Versus Laparoscopic Distal Resection and Enucleation for Potentially Benign Pancreatic Neoplasms. Surg Today. 2020;50(8):872-880. PubMed PMID: 32016613.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A retrospective comparison of robotic versus laparoscopic distal resection and enucleation for potentially benign pancreatic neoplasms. AU - Najafi,Nawid, AU - Mintziras,I, AU - Wiese,D, AU - Albers,M B, AU - Maurer,E, AU - Bartsch,D K, Y1 - 2020/02/03/ PY - 2019/09/06/received PY - 2020/01/05/accepted PY - 2020/2/6/pubmed PY - 2020/9/22/medline PY - 2020/2/5/entrez KW - Laparoscopic pancreatectomy KW - Laparoscopic pancreatic enucleation KW - Minimally invasive surgery KW - Robotic pancreatic enucleation KW - Robotic-assisted pancreatectomy SP - 872 EP - 880 JF - Surgery today JO - Surg Today VL - 50 IS - 8 N2 - PURPOSE: The present study aimed to compare robotic-assisted versus laparoscopic distal pancreatic resection and enucleation for potentially benign pancreatic neoplasms. METHODS: Patients were retrieved from a prospectively maintained database. Demographic data, tumor types, and the perioperative outcomes were retrospectively analyzed. RESULTS: In a 10-year period, 75 patients (female, n = 44; male, n = 31; median age, 53 years [range, 9-84 years]) were identified. The majority of patients had pancreatic neuroendocrine neoplasms (n = 39, 52%) and cystic neoplasms (n = 23, 31%) with a median tumor size of 17 (3-60) mm. Nineteen (25.3%) patients underwent enucleation (robotic, n = 11; laparoscopic, n = 8) and 56 (74.7%) patients underwent distal pancreatic resection (robotic, n = 24; laparoscopic, n = 32), of those 48 (85%) underwent spleen-preserving procedures. Eight (10.7%) procedures had to be converted to open surgery. The rate of vessel preservation in distal pancreatectomy was significantly higher in robotic-assisted procedures (62.5% vs. 12.5%, p = 0.01). Twenty-six (34.6%) patients experienced postoperative complications (Clavien-Dindo grade > 3). Twenty (26.7%) patients developed a pancreatic fistula type B. There was no mortality. After a median follow-up period of 58 months (range 2-120 months), one patient (1.3%) developed local recurrence (glucagonoma) after enucleation, which was treated with a Whipple procedure. CONCLUSION: The robotic approach is comparably safe, but increases the rate of splenic vessel preservation and reduces the risk of conversion to open surgery. SN - 1436-2813 UR - https://www.unboundmedicine.com/medline/citation/32016613/A_retrospective_comparison_of_robotic_versus_laparoscopic_distal_resection_and_enucleation_for_potentially_benign_pancreatic_neoplasms_ L2 - https://dx.doi.org/10.1007/s00595-020-01966-z DB - PRIME DP - Unbound Medicine ER -