胰腺癌的机器人与腹腔镜胰十二指肠切除术：手术疗效的评估和分析
Robotic Versus Laparoscopic Pancreaticoduodenectomy for Pancreatic Cancer: Evaluation and Analysis of Surgical Efficacy
影响因子:3.50000
分区:医学2区 / 外科2区 肿瘤学3区
发表日期:2024 Oct
作者:
Menghua Dai, Lixin Chen, Qiang Xu, Ming Cui, Pengyu Li, Wenjing Liu, Chen Lin, Weijie Chen, Haomin Chen, Shuai Yuan
摘要
在微创胰腺十二指肠切除术中治疗胰腺癌的证据受到限制。此回顾性分析评估了接受机器人胰十二指肠切除术（RPD）或腹腔镜胰腺切除术或2016年4月6日至2023年4月的时间和平面的患者。分析了严重的并发症率，并收集了随访数据，例如无病生存率（DFS）和总生存率（OS）。总共进行了253例LPD和RPD病例，其中包括101例胰腺癌病例，其中54例是LPD和47例RPD。 RPD组的转化率（4.3％比29.6％，P = 0.001）和失血率（400 vs. 575 mL，P <0.05）较低。两组在手术时间，血管切除率和TNM阶段诊断方面没有观察到显着差异。但是，R0切除率（80.9％比70.4％）和淋巴结收获（24.2 vs. 21.9）的RPD组较高，术后住院时间在RPD队列中更短（11 vs. 13天）。此外，提高了1至3年的DFS（75.7％，61.7％和36.0％，36.0％，59.0％，35.6％和21.9％）和OS（94.7％，84.7％，50.8％和50.8％和50.8％和84.1％，63.6％和45.5％）与RPD组相比，在RPD组中有LPD组的安全性。与LPD相比，肿瘤学结果与围手术期结果的后者相似。长期结果需要进一步研究。
Abstract
Evidence is limited for the treatment of pancreatic cancer among minimally invasive pancreatoduodenectomy.This retrospective analysis evaluated patients who underwent robotic pancreaticoduodenectomy (RPD) or laparoscopic pancreaticoduodenectomy (LPD) from April 2016 to April 2023. Their baseline and perioperative data, including operative time, R0 resection rates, and severe complications rates, were analyzed, and the follow-up data, such as disease-free survival (DFS) and overall survival (OS), were collected.A total of 253 cases of LPD and RPD were performed, and 101 cases with pancreatic cancer were included, of which 54 were LPD and 47 were RPD. The conversion rate (4.3% vs. 29.6%, p = 0.001) and blood loss (400 vs. 575 mL, p < 0.05) were lower in the RPD group. No significant difference was observed between the two groups in terms of operative time, vessel resection rates, and TNM-stage diagnosis; however, R0 resection rates (80.9% vs. 70.4%) and lymph node harvest (24.2 vs. 21.9) had a higher tendency in the RPD group, and postoperative length of stay was shorter in the RPD cohort (11 vs. 13 days). Moreover, improved 1- to 3-years DFS (75.7%, 61.7%, and 36.0% vs. 59.0%, 35.6%, and 21.9%) and OS (94.7%, 84.7%, and 50.8% vs. 84.1%, 63.6%, and 45.5%) was found in the RPD group in comparison with the LPD group.RPD had advantages in surgical safety and oncological outcomes compared with LPD, but was similar to the latter in perioperative outcomes. Long-term outcomes require further study.