Cho-Han Chiang1,2, Cho-Hsien Chiang3,4, Teng-Chieh Cheng4, Cho-Hung Chiang5, Ching-Lung Hsieh3,4, Jhong-I Peng3,4, Cheng-Ming Peng6,7. 1. Master of Medical Sciences in Clinical Investigation, Harvard Medical School, Boston, MA, USA. 2. School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. 3. Department of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Chien-Kuo N. Rd., Taichung, 40201, Taiwan. 4. Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, No. 110, Sec. 1, Chien-Kuo N. Rd., Taichung, 40201, Taiwan. 5. Division of General Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Foundation, New Taipei City, Taiwan. 6. Department of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Chien-Kuo N. Rd., Taichung, 40201, Taiwan. jimy5989@gmail.com. 7. Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, No. 110, Sec. 1, Chien-Kuo N. Rd., Taichung, 40201, Taiwan. jimy5989@gmail.com.
Abstract
BACKGROUND AND OBJECTIVES: Multiple-port robotic pancreaticoduodenectomy (RPD) has been increasingly used as an alternative to open pancreaticoduodenectomy (OPD) in pancreatic cancer. However, the comparative safety and efficacy of reduced-port RPD versus OPD are unknown. METHODS: This was a prospective cohort study comprising adult patients who underwent reduced-port RPD (single-port or single-site plus one port) or OPD for malignant tumors of the pancreas and periampullary region from July 2015 to October 2020 at a single center. We collected data on the patient demographics, perioperative results, oncologic outcomes, and one-year survival. RESULTS: Forty-five patients underwent reduced-port RPD, and 13 underwent OPD. There were no significant differences in the age, sex, body mass index, ASA score, tumor location, or occurrences of postoperative complications between the two groups. Compared with OPD, reduced-port RPD was associated with less blood loss (300 ml [95% confidence interval {CI} 155-700] vs. 650 ml [95% CI 300-850], p value = 0.11) but a longer operative time (325 min [95% CI 290-370] vs. 215 min [95% CI 180-270], p value < 0.001). Compared with patients who underwent OPD, patients who underwent reduced-port RPD had a higher 1-year survival rate (68% [95% CI 49-81] vs. 22% [95% CI 3-51], log-rank, p value = 0.007). CONCLUSIONS: Reduced-port RPD can be safely performed in experienced surgeons and is associated with better perioperative and oncologic outcomes than OPD.
BACKGROUND AND OBJECTIVES: Multiple-port robotic pancreaticoduodenectomy (RPD) has been increasingly used as an alternative to open pancreaticoduodenectomy (OPD) in pancreatic cancer. However, the comparative safety and efficacy of reduced-port RPD versus OPD are unknown. METHODS: This was a prospective cohort study comprising adult patients who underwent reduced-port RPD (single-port or single-site plus one port) or OPD for malignant tumors of the pancreas and periampullary region from July 2015 to October 2020 at a single center. We collected data on the patient demographics, perioperative results, oncologic outcomes, and one-year survival. RESULTS: Forty-five patients underwent reduced-port RPD, and 13 underwent OPD. There were no significant differences in the age, sex, body mass index, ASA score, tumor location, or occurrences of postoperative complications between the two groups. Compared with OPD, reduced-port RPD was associated with less blood loss (300 ml [95% confidence interval {CI} 155-700] vs. 650 ml [95% CI 300-850], p value = 0.11) but a longer operative time (325 min [95% CI 290-370] vs. 215 min [95% CI 180-270], p value < 0.001). Compared with patients who underwent OPD, patients who underwent reduced-port RPD had a higher 1-year survival rate (68% [95% CI 49-81] vs. 22% [95% CI 3-51], log-rank, p value = 0.007). CONCLUSIONS: Reduced-port RPD can be safely performed in experienced surgeons and is associated with better perioperative and oncologic outcomes than OPD.
Keywords:
Pancreatic cancer; Pancreaticoduodenectomy; Robotic pancreaticoduodenectomy; Single-port pancreaticoduodenectomy; Single-site plus one port pancreaticoduodenectomy; Whipple operation
Authors: Hari T Vigneswaran; Logan S Schwarzman; Simone Francavilla; Michael R Abern; Simone Crivellaro Journal: Eur Urol Date: 2020-04-09 Impact factor: 20.096
Authors: W S Tummers; J V Groen; B G Sibinga Mulder; A Farina-Sarasqueta; J Morreau; H Putter; C J van de Velde; A L Vahrmeijer; B A Bonsing; J S Mieog; R J Swijnenburg Journal: Br J Surg Date: 2019-03-18 Impact factor: 6.939