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01-12-2020 | Pancreatoduodenostomy

Single-centre comparison of robotic and open pancreatoduodenectomy: a propensity score-matched study

Authors: Lapo Bencini, Federica Tofani, Claudia Paolini, Carla Vaccaro, Paolo Checcacci, Mario Annecchiarico, Luca Moraldi, Marco Farsi, Simone Polvani, Andrea Coratti

Published in: Surgical Endoscopy | Issue 12/2020

Abstract

Background

Pancreatoduodenectomy for pancreatic head and periampullary cancers is still associated with high perioperative morbidity and mortality. The aim of this study was to compare the short-term outcomes of robot-assisted pancreatoduodenectomy (RAPD) and open pancreatoduodenectomy (OPD) performed in a high-volume centre.

Methods

A single-centre, prospective database was used to retrospectively compare the early outcomes of RAPD procedures to standard OPD procedures completed between January 2014 and December 2018. Of the 121 included patients, 78 underwent RAPD and 43 underwent OPD. After propensity score matching (PSM), 35 RAPD patients were matched with 35 OPD patients with similar preoperative characteristics.

Results

There were no statistically significant differences in most of the baseline demographics and perioperative outcomes in the two groups after PSM optimization with the exception of the operative time (530 min (RAPD) versus 335 min (OPD) post-match, p < 0.000). No differences were found between the two groups in terms of complications (including pancreatic leaks, 11.4% in both OPD and RAPD), perioperative mortality, reoperations or readmissions. Earlier refeeding was obtained in the RAPD group vs. the OPD group (3 vs. 4 days, p = 0.002). Although the differences in the length of the hospital stay and blood transfusions were not statistically significant, both parameters showed a positive trend in favour of RAPD. The number of harvested lymph nodes was similar and oncologically adequate.

Conclusions

RAPD is a safe and oncologically adequate technique to treat malignancies arising from the pancreatic head and periampullary region. Several perioperative parameters resulted in trends favouring RAPD over OPD, at the price of longer operating time. Data should be reinforced with a larger sample to guarantee statistical significance.

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Title: Single-centre comparison of robotic and open pancreatoduodenectomy: a propensity score-matched study
Authors: Lapo Bencini
Federica Tofani
Claudia Paolini
Carla Vaccaro
Paolo Checcacci
Mario Annecchiarico
Luca Moraldi
Marco Farsi
Simone Polvani
Andrea Coratti
Publication date: 01-12-2020
Publisher: Springer US
Keywords: Pancreatoduodenostomy
Pancreatoduodenostomy
Pancreatic Surgery
Pancreatic Surgery
Published in: Surgical Endoscopy / Issue 12/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-07335-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Single-centre comparison of robotic and open pancreatoduodenectomy: a propensity score-matched study

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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