Total laparoscopic versus robotic-assisted laparoscopic pancreaticoduodenectomy: which one is better?
Background Minimally invasive pancreaticoduodenectomy (MIPD) is a challenging procedure. Laparoscopic pancreaticoduodenectomy (LPD) is feasible and safe. Since the development of robotic platforms, the number of reports on robot-assisted pancreatic surgery has increased. We compared the technical fe...
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| Veröffentlicht in: | Surgical endoscopy 2022-12, Vol.36 (12), p.8959-8966 |
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| creator | Choi, Munseok Rho, Seoung Yoon Kim, Sung Hyun Hwang, Ho Kyoung Lee, Woo Jung Kang, Chang Moo |
| description | Background
Minimally invasive pancreaticoduodenectomy (MIPD) is a challenging procedure. Laparoscopic pancreaticoduodenectomy (LPD) is feasible and safe. Since the development of robotic platforms, the number of reports on robot-assisted pancreatic surgery has increased. We compared the technical feasibility and safety between LPD and robot-assisted LPD (RALPD).
Methods
From September 2012 to August 2020, 257 patients who underwent MIPD for periampullary tumors were enrolled. Of these, 207 underwent LPD and 50 underwent RALPD. We performed a 1:1 propensity score-matched (PSM) analysis and retrospectively analyzed the demographics and surgical outcomes.
Results
After PSM analysis, no difference was noted in demographics. Operation times and estimated blood loss were similar, as was the incidence of complications (
p
> 0.05). In subgroup analysis in patients with soft pancreas with pancreatic duct ≤ 2 mm, no significant between-group difference was noted regarding short-term surgical outcomes, including clinically relevant POPF (CR-POPF) (
p
> 0.05). In multivariable analysis, the only soft pancreatic texture was a predictive factor (HR 3.887, 95% confidence interval 1.121–13.480,
p
= 0.032).
Conclusion
RALPD and LPD are safe and effective for MIPD and can compensate each other to achieve the goal of minimally invasive surgery. |
| doi_str_mv | 10.1007/s00464-022-09347-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2676553041</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2735408858</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-4c93dc5aabec9dfc297fe076614ba178f576153a910b9dfec7b2d061f0331ea03</originalsourceid><addsrcrecordid>eNp9kctKxTAQhoMoery8gAspuHETndya1o2IeAPBja5Dmk610tPUpFXO2xs9XtCFq4GZb_65_ITsMjhkAPooAshcUuCcQimkposVMmNScMo5K1bJLGWBcl3KDbIZ4xMkvmRqnWwIlZe6UHxG8M6Ptss6O9jgo_ND67IXDHGKWfCVH1tHbYxtHLH-DQ22dwFtAnw9-Rp7dKOfL46z18fWPWa-x6yNWYXjiOFkm6w1tou48xm3yP3F-d3ZFb25vbw-O72hTmg1UulKUTtlbYWurBvHS90g6DxnsrJMF43SOVPClgyqVEenK15DzhoQgqEFsUUOlrpD8M8TxtHM2-iw62yPfoqG5zpXSoBkCd3_gz75KfRpO8O1UBKKQhWJ4kvKpcNjwMYMoZ3bsDAMzLsJZmmCSSaYDxPMIjXtfUpP1Rzr75avrydALIGYSv0Dhp_Z_8i-ATbIlMU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2735408858</pqid></control><display><type>article</type><title>Total laparoscopic versus robotic-assisted laparoscopic pancreaticoduodenectomy: which one is better?</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Choi, Munseok ; Rho, Seoung Yoon ; Kim, Sung Hyun ; Hwang, Ho Kyoung ; Lee, Woo Jung ; Kang, Chang Moo</creator><creatorcontrib>Choi, Munseok ; Rho, Seoung Yoon ; Kim, Sung Hyun ; Hwang, Ho Kyoung ; Lee, Woo Jung ; Kang, Chang Moo</creatorcontrib><description>Background
Minimally invasive pancreaticoduodenectomy (MIPD) is a challenging procedure. Laparoscopic pancreaticoduodenectomy (LPD) is feasible and safe. Since the development of robotic platforms, the number of reports on robot-assisted pancreatic surgery has increased. We compared the technical feasibility and safety between LPD and robot-assisted LPD (RALPD).
Methods
From September 2012 to August 2020, 257 patients who underwent MIPD for periampullary tumors were enrolled. Of these, 207 underwent LPD and 50 underwent RALPD. We performed a 1:1 propensity score-matched (PSM) analysis and retrospectively analyzed the demographics and surgical outcomes.
Results
After PSM analysis, no difference was noted in demographics. Operation times and estimated blood loss were similar, as was the incidence of complications (
p
> 0.05). In subgroup analysis in patients with soft pancreas with pancreatic duct ≤ 2 mm, no significant between-group difference was noted regarding short-term surgical outcomes, including clinically relevant POPF (CR-POPF) (
p
> 0.05). In multivariable analysis, the only soft pancreatic texture was a predictive factor (HR 3.887, 95% confidence interval 1.121–13.480,
p
= 0.032).
Conclusion
RALPD and LPD are safe and effective for MIPD and can compensate each other to achieve the goal of minimally invasive surgery.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-022-09347-y</identifier><identifier>PMID: 35697852</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Bile ducts ; Body mass index ; Cancer ; Endoscopy ; Gastroenterology ; Gynecology ; Hepatology ; Hospitals ; Humans ; Laparoscopy ; Laparoscopy - methods ; Lymphatic system ; Medical schools ; Medicine ; Medicine & Public Health ; Minimally invasive surgery ; Pancreatectomy - adverse effects ; Pancreatic Fistula - etiology ; Pancreatic Neoplasms - complications ; Pancreatic Neoplasms - surgery ; Pancreaticoduodenectomy ; Pancreaticoduodenectomy - methods ; Patients ; Population ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Proctology ; Retrospective Studies ; Robotic surgery ; Robotic Surgical Procedures - adverse effects ; Surgery ; Surgical outcomes ; Tumors ; University colleges ; Veins & arteries</subject><ispartof>Surgical endoscopy, 2022-12, Vol.36 (12), p.8959-8966</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-4c93dc5aabec9dfc297fe076614ba178f576153a910b9dfec7b2d061f0331ea03</citedby><cites>FETCH-LOGICAL-c375t-4c93dc5aabec9dfc297fe076614ba178f576153a910b9dfec7b2d061f0331ea03</cites><orcidid>0000-0001-7683-9687</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-022-09347-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-022-09347-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35697852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choi, Munseok</creatorcontrib><creatorcontrib>Rho, Seoung Yoon</creatorcontrib><creatorcontrib>Kim, Sung Hyun</creatorcontrib><creatorcontrib>Hwang, Ho Kyoung</creatorcontrib><creatorcontrib>Lee, Woo Jung</creatorcontrib><creatorcontrib>Kang, Chang Moo</creatorcontrib><title>Total laparoscopic versus robotic-assisted laparoscopic pancreaticoduodenectomy: which one is better?</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Minimally invasive pancreaticoduodenectomy (MIPD) is a challenging procedure. Laparoscopic pancreaticoduodenectomy (LPD) is feasible and safe. Since the development of robotic platforms, the number of reports on robot-assisted pancreatic surgery has increased. We compared the technical feasibility and safety between LPD and robot-assisted LPD (RALPD).
Methods
From September 2012 to August 2020, 257 patients who underwent MIPD for periampullary tumors were enrolled. Of these, 207 underwent LPD and 50 underwent RALPD. We performed a 1:1 propensity score-matched (PSM) analysis and retrospectively analyzed the demographics and surgical outcomes.
Results
After PSM analysis, no difference was noted in demographics. Operation times and estimated blood loss were similar, as was the incidence of complications (
p
> 0.05). In subgroup analysis in patients with soft pancreas with pancreatic duct ≤ 2 mm, no significant between-group difference was noted regarding short-term surgical outcomes, including clinically relevant POPF (CR-POPF) (
p
> 0.05). In multivariable analysis, the only soft pancreatic texture was a predictive factor (HR 3.887, 95% confidence interval 1.121–13.480,
p
= 0.032).
Conclusion
RALPD and LPD are safe and effective for MIPD and can compensate each other to achieve the goal of minimally invasive surgery.</description><subject>Abdominal Surgery</subject><subject>Bile ducts</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Endoscopy</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Lymphatic system</subject><subject>Medical schools</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minimally invasive surgery</subject><subject>Pancreatectomy - adverse effects</subject><subject>Pancreatic Fistula - etiology</subject><subject>Pancreatic Neoplasms - complications</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Pancreaticoduodenectomy</subject><subject>Pancreaticoduodenectomy - methods</subject><subject>Patients</subject><subject>Population</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - adverse effects</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Tumors</subject><subject>University colleges</subject><subject>Veins & arteries</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kctKxTAQhoMoery8gAspuHETndya1o2IeAPBja5Dmk610tPUpFXO2xs9XtCFq4GZb_65_ITsMjhkAPooAshcUuCcQimkposVMmNScMo5K1bJLGWBcl3KDbIZ4xMkvmRqnWwIlZe6UHxG8M6Ptss6O9jgo_ND67IXDHGKWfCVH1tHbYxtHLH-DQ22dwFtAnw9-Rp7dKOfL46z18fWPWa-x6yNWYXjiOFkm6w1tou48xm3yP3F-d3ZFb25vbw-O72hTmg1UulKUTtlbYWurBvHS90g6DxnsrJMF43SOVPClgyqVEenK15DzhoQgqEFsUUOlrpD8M8TxtHM2-iw62yPfoqG5zpXSoBkCd3_gz75KfRpO8O1UBKKQhWJ4kvKpcNjwMYMoZ3bsDAMzLsJZmmCSSaYDxPMIjXtfUpP1Rzr75avrydALIGYSv0Dhp_Z_8i-ATbIlMU</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Choi, Munseok</creator><creator>Rho, Seoung Yoon</creator><creator>Kim, Sung Hyun</creator><creator>Hwang, Ho Kyoung</creator><creator>Lee, Woo Jung</creator><creator>Kang, Chang Moo</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7683-9687</orcidid></search><sort><creationdate>20221201</creationdate><title>Total laparoscopic versus robotic-assisted laparoscopic pancreaticoduodenectomy: which one is better?</title><author>Choi, Munseok ; Rho, Seoung Yoon ; Kim, Sung Hyun ; Hwang, Ho Kyoung ; Lee, Woo Jung ; Kang, Chang Moo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-4c93dc5aabec9dfc297fe076614ba178f576153a910b9dfec7b2d061f0331ea03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal Surgery</topic><topic>Bile ducts</topic><topic>Body mass index</topic><topic>Cancer</topic><topic>Endoscopy</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Lymphatic system</topic><topic>Medical schools</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Minimally invasive surgery</topic><topic>Pancreatectomy - adverse effects</topic><topic>Pancreatic Fistula - etiology</topic><topic>Pancreatic Neoplasms - complications</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Pancreaticoduodenectomy</topic><topic>Pancreaticoduodenectomy - methods</topic><topic>Patients</topic><topic>Population</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - adverse effects</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Tumors</topic><topic>University colleges</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Munseok</creatorcontrib><creatorcontrib>Rho, Seoung Yoon</creatorcontrib><creatorcontrib>Kim, Sung Hyun</creatorcontrib><creatorcontrib>Hwang, Ho Kyoung</creatorcontrib><creatorcontrib>Lee, Woo Jung</creatorcontrib><creatorcontrib>Kang, Chang Moo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choi, Munseok</au><au>Rho, Seoung Yoon</au><au>Kim, Sung Hyun</au><au>Hwang, Ho Kyoung</au><au>Lee, Woo Jung</au><au>Kang, Chang Moo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Total laparoscopic versus robotic-assisted laparoscopic pancreaticoduodenectomy: which one is better?</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>36</volume><issue>12</issue><spage>8959</spage><epage>8966</epage><pages>8959-8966</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Minimally invasive pancreaticoduodenectomy (MIPD) is a challenging procedure. Laparoscopic pancreaticoduodenectomy (LPD) is feasible and safe. Since the development of robotic platforms, the number of reports on robot-assisted pancreatic surgery has increased. We compared the technical feasibility and safety between LPD and robot-assisted LPD (RALPD).
Methods
From September 2012 to August 2020, 257 patients who underwent MIPD for periampullary tumors were enrolled. Of these, 207 underwent LPD and 50 underwent RALPD. We performed a 1:1 propensity score-matched (PSM) analysis and retrospectively analyzed the demographics and surgical outcomes.
Results
After PSM analysis, no difference was noted in demographics. Operation times and estimated blood loss were similar, as was the incidence of complications (
p
> 0.05). In subgroup analysis in patients with soft pancreas with pancreatic duct ≤ 2 mm, no significant between-group difference was noted regarding short-term surgical outcomes, including clinically relevant POPF (CR-POPF) (
p
> 0.05). In multivariable analysis, the only soft pancreatic texture was a predictive factor (HR 3.887, 95% confidence interval 1.121–13.480,
p
= 0.032).
Conclusion
RALPD and LPD are safe and effective for MIPD and can compensate each other to achieve the goal of minimally invasive surgery.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35697852</pmid><doi>10.1007/s00464-022-09347-y</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7683-9687</orcidid></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Bile ducts Body mass index Cancer Endoscopy Gastroenterology Gynecology Hepatology Hospitals Humans Laparoscopy Laparoscopy - methods Lymphatic system Medical schools Medicine Medicine & Public Health Minimally invasive surgery Pancreatectomy - adverse effects Pancreatic Fistula - etiology Pancreatic Neoplasms - complications Pancreatic Neoplasms - surgery Pancreaticoduodenectomy Pancreaticoduodenectomy - methods Patients Population Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - surgery Proctology Retrospective Studies Robotic surgery Robotic Surgical Procedures - adverse effects Surgery Surgical outcomes Tumors University colleges Veins & arteries |
| title | Total laparoscopic versus robotic-assisted laparoscopic pancreaticoduodenectomy: which one is better? |
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