Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study.

Autor:	van Bodegraven EA; Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, The Netherlands., van Ramshorst TME; Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, The Netherlands.; Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy., Bratlie SO; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden., Kokkola A; Department of Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland., Sparrelid E; Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden., Björnsson B; Department of Surgery in Linköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden., Kleive D; Department of HPB Surgery, The Intervention Centre, Oslo University Hospital and Institute for Clinical Medicine, Oslo, Norway., Burgdorf SK; Department of Surgery and Transplantation, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark., Dokmak S; Departement of HPB Surgery and Liver Transplantation, APHP Beaujon Hospital, University of Paris Cité, Clichy, France., Groot Koerkamp B; Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Cabús SS; Department of HPB Surgery, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain., Molenaar IQ; Department of Surgery, Regional Academic Cancer Centre Utrecht, UMC Utrecht Cancer Centre and St Antonius Hospital Nieuwegein, University Medical Centre Utrecht, Utrecht, The Netherlands., Boggi U; Division of General and Transplant Surgery, University of Pisa, Pisa, Italy., Busch OR; Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, The Netherlands., Petrič M; Department of Abdominal Surgery, Ljubljana University Medical Center, Zaloška cesta, Ljubljana, Slovenia., Roeyen G; Department of HPB, Endocrine and Transplantation Surgery, University Hospital Antwerp, Edegem, Belgium and University of Antwerp, Wilrijk, Belgium., Hackert T; Department of Surgery, Heidelberg University Hospital, Heidelberg, Germany., Lips DJ; Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherland., D'Hondt M; Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium., Coolsen MME; Department of Surgery, Maastricht University Medical Center+, University of Maastricht, Maastricht, The Netherlands., Ferrari G; Division of Minimally Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., Tingstedt B; Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden., Serrablo A; HPB Surgical Division, Miguel Servet University Hospital, Zaragoza, Spain., Gaujoux S; Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France., Ramera M; Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Khatkov I; Department of Surgery, Moscow Clinical Scientific Center, Moscow, Russia., Ausania F; Department of HPB and Transplant Surgery, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain., Souche R; Department of Surgery, Saint-Éloi Hospital, Montpellier, France., Festen S; Department of Surgery, OLVG, Amsterdam, The Netherlands., Berrevoet F; Department of General and HPB Surgery and Liver Transplantation, Ghent University Hospital, Ghent, Belgium., Keck T; Department of Surgery, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany., Sutcliffe RP; Department of Hepatopancreatobiliary Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Pando E; Department of Hepato, Pancreato, Biliary, and Transplant Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain., de Wilde RF; Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Aussilhou B; Departement of HPB Surgery and Liver Transplantation, APHP Beaujon Hospital, University of Paris Cité, Clichy, France., Krohn PS; Department of Surgery and Transplantation, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark., Edwin B; Department of HPB Surgery, The Intervention Centre, Oslo University Hospital and Institute for Clinical Medicine, Oslo, Norway., Sandström P; Department of Surgery in Linköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden., Gilg S; Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden., Seppänen H; Department of Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland., Vilhav C; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden., Abu Hilal M; Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy., Besselink MG; Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	International journal of surgery (London, England) [Int J Surg] 2024 Jun 01; Vol. 110 (6), pp. 3554-3561. Date of Electronic Publication: 2024 Jun 01.
DOI:	10.1097/JS9.0000000000001315
Abstrakt:	Background: International guidelines recommend monitoring the use and outcome of minimally invasive pancreatic surgery (MIPS). However, data from prospective international audits on minimally invasive distal pancreatectomy (MIDP) are lacking. This study examined the use and outcome of robot-assisted (RDP) and laparoscopic (LDP) distal pancreatectomy in the E-MIPS registry. Patients and Methods: Post-hoc analysis in a prospective audit on MIPS, including consecutive patients undergoing MIDP in 83 centers from 19 European countries (01-01-2019/31-12-2021). Primary outcomes included intraoperative events (grade 1: excessive blood loss, grade 2: conversion/change in operation, grade 3: intraoperative death), major morbidity, and in-hospital/30-day mortality. Multivariable logistic regression analyses identified high-risk groups for intraoperative events. RDP and LDP were compared in the total cohort and high-risk groups. Results: Overall, 1672 patients undergoing MIDP were included; 606 (36.2%) RDP and 1066 (63.8%) LDP. The annual use of RDP increased from 30.5% to 42.6% ( P <0.001). RDP was associated with fewer grade 2 intraoperative events compared with LDP (9.6% vs. 16.8%, P <0.001), with longer operating time (238 vs. 201 min, P <0.001). No significant differences were observed between RDP and LDP regarding major morbidity (23.4% vs. 25.9%, P =0.264) and in-hospital/30-day mortality (0.3% vs. 0.8%, P =0.344). Three high-risk groups were identified; BMI greater than 25 kg/m 2 , previous abdominal surgery, and vascular involvement. In each group, RDP was associated with fewer conversions and longer operative times. Conclusion: This European registry-based study demonstrated favorable outcomes for MIDP, with mortality rates below 1%. LDP remains the predominant approach, whereas the use of RDP is increasing. RDP was associated with fewer conversions and longer operative time, including in high-risk subgroups. Future randomized trials should confirm these findings and assess cost differences. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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