Background: Cystic pancreatic lesions are increasingly found incidentally. Their management may be difficult because often the distinction within this heterogeneous group of pathologies may not be possible, despite intensive investigations. Our study aims to compare the robotic assisted surgical (RAS) approach with the open surgery (OS) in the surgical management of cystic lesions of the body and tail of the pancreas, with a view to documenting benefits from the more expensive robotic approach. Materials and methods: From April 2010 to April 2017, 37 robotic-assisted distal pancreatectomy (DP) for lesions of the body/tail of the pancreas were performed, of which 27 were performed in patients who had cystic tumors (RAS-group). Baseline features, surgical outcomes and histopathological examination were compared retrospectively with a group of 27 patients treated with open surgery from May 2005 to April 2010, selected from the institutional prospectively collected database (OS-Group). Results: The spleen-preserving rate was significantly higher in the RAS group (63% vs. 33.3% in the OS-Group, p<0.05). No difference in the post-operative pancreatic fistula and morbidity was found between the two groups. The median postoperative length of hospital stay was significantly shorter in the RAS-group: 8 days (range 3-25) vs. 12 days (range 7-26) in the OS-Group (p<0.01). No conversion to open approach was reported in the RAS-group. Conclusions: The robot-assisted DP is a safe and effective procedure. The robotic approach significantly increases the spleen preservation rate and reduces the post-operative hospital stay. By reducing the trauma of access, it results in smoother post-operative course and faster recovery. This is particularly important in patients with cystic pancreatic tumors, in increasing their acceptance for surgery when recommended. Prospective studies are necessary to validate the clinical benefits of robotic approach for DP.
ROBOTIC ASSISTED VERSUS OPEN DISTAL PANCREATECTOMY FOR CYSTIC TUMORS: A SINGLE CENTER EXPERIENCE
Di Franco G;FURBETTA, NICCOLO';PALMERI, MATTEO;GUADAGNI, SIMONE;GIANARDI, DESIRÉE;CASCIONE, FRANCESCA;MOSCA, FRANCO;MORELLI, LUCA
2017-01-01
Abstract
Background: Cystic pancreatic lesions are increasingly found incidentally. Their management may be difficult because often the distinction within this heterogeneous group of pathologies may not be possible, despite intensive investigations. Our study aims to compare the robotic assisted surgical (RAS) approach with the open surgery (OS) in the surgical management of cystic lesions of the body and tail of the pancreas, with a view to documenting benefits from the more expensive robotic approach. Materials and methods: From April 2010 to April 2017, 37 robotic-assisted distal pancreatectomy (DP) for lesions of the body/tail of the pancreas were performed, of which 27 were performed in patients who had cystic tumors (RAS-group). Baseline features, surgical outcomes and histopathological examination were compared retrospectively with a group of 27 patients treated with open surgery from May 2005 to April 2010, selected from the institutional prospectively collected database (OS-Group). Results: The spleen-preserving rate was significantly higher in the RAS group (63% vs. 33.3% in the OS-Group, p<0.05). No difference in the post-operative pancreatic fistula and morbidity was found between the two groups. The median postoperative length of hospital stay was significantly shorter in the RAS-group: 8 days (range 3-25) vs. 12 days (range 7-26) in the OS-Group (p<0.01). No conversion to open approach was reported in the RAS-group. Conclusions: The robot-assisted DP is a safe and effective procedure. The robotic approach significantly increases the spleen preservation rate and reduces the post-operative hospital stay. By reducing the trauma of access, it results in smoother post-operative course and faster recovery. This is particularly important in patients with cystic pancreatic tumors, in increasing their acceptance for surgery when recommended. Prospective studies are necessary to validate the clinical benefits of robotic approach for DP.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
