Comparison of efficacy and safety between robotic and laparoscopic pancreatic tumor enucleation
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1.Department of Hepatobiliary and Pancreatic Surgery Ⅱ, the Third Xiangya Hospital, Central South University, Changsha 410013, China;2.Department of Surgery Ⅰ, General Hospital of People's Armed Police Force of Hunan Province, Changsha 410006, China

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R735.9

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    Abstract:

    Background and Aims In the era of minimally invasive surgery, the role of pancreatic tumor enucleation (PTE) in treating benign or low-grade malignant tumors is gaining attention. The Da Vinci robot offers advantages such as enhanced visualization and flexible instrument manipulation, which can ensure the safe implementation of PTE. However, whether robotic pancreatic tumor excision (RPTE) is superior to laparoscopic pancreatic tumor enucleation (LPTE) remains undetermined. Therefore, this study was performed to explore this aspect.Methods The clinical data of 38 patients who underwent surgical treatment for benign or low-grade malignant tumors in the Third Xiangya Hospital of Central South University from April 2020 to May 2024 were collected. Among them, 18 cases underwent RPTE (RPTE group), and 20 cases underwent LPTE (LPTE group). Relevant clinical variables were compared between the two groups, and subgroup comparisons were further conducted for patients with tumors in the head and neck/body/tail of the pancreas.Results The average operative time for the entire group was 125 min, with an average intraoperative blood loss of 67.89 mL, and no C-grade pancreatic fistula occurred. The incidence rates of B-grade pancreatic fistula, postoperative bleeding, and readmission were 39.5%, 21.1%, and 18.4%, respectively, with an average postoperative hospital stay of 11.44 d. Overall, the RPTE group had shorter operative time and less intraoperative blood loss than the LPTE group (both P<0.05). There were no statistically significant differences between the two groups regarding the incidence of B-grade pancreatic fistula, intraoperative bleeding, readmission rate, and postoperative hospital stay (all P>0.05). Subgroup analysis showed that for patients with head tumors, the RPTE group had shorter operative time, less intraoperative blood loss, and a lower incidence of postoperative bleeding than the LPTE group (all P<0.05). However, the differences in the incidence of B-grade pancreatic fistula, readmission rate, and postoperative hospital stay were not statistically significant (all P>0.05). In patients with neck/body/tail tumors, the RPTE group also had shorter operative time and less intraoperative blood loss (both P<0.05), but the differences in incidence of B-grade pancreatic fistula, incidence of postoperative bleeding, readmission rate, and postoperative hospital stay were not statistically significant (all P>0.05).Conclusion Minimally invasive PTE for the treatment of benign or low-grade malignant pancreatic tumors is safe. Compared to LPTE, RPTE can significantly reduce operative time and intraoperative blood loss and shows certain advantages in reducing postoperative complications, particularly for patients with head tumors. However, the conclusion of this study needs to be confirmed by larger prospective studies.

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LI Zhiqiang, SUN Jichun, TU Guangping, XIE Shuangxi, LIU Yunfei, WANG Dongwen, HE Shunmin, YU Xiao. Comparison of efficacy and safety between robotic and laparoscopic pancreatic tumor enucleation[J]. Chin J Gen Surg,2024,33(9):1430-1439.
DOI:10.7659/j. issn.1005-6947.2024.09.010

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History
  • Received:July 01,2024
  • Revised:September 09,2024
  • Adopted:
  • Online: October 12,2024
  • Published: