Minimally invasive distal pancreatectomy for pancreatic adenocarcinoma: A propensity-matched national analysis on surgical outcomes and healthcare disparities.

Autor: Ganduboina R; NRI Institute of Medical Sciences, Visakhapatnam, India., Dutta P; Kyiv Medical University, Kyiv, Ukraine. Electronic address: duttapalak05@gmail.com., Pawar SG; Cedars Sinai Medical Center, Los Angeles, USA., Mukherjee I; Staten Island University Hospital - Northwell Health, USA.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Oct; Vol. 236, pp. 115897. Date of Electronic Publication: 2024 Aug 14.
DOI: 10.1016/j.amjsurg.2024.115897
Abstrakt: Background: Pancreatic adenocarcinoma of distal pancreas is hard to treat due to late presentation. While open distal pancreatectomy with splenectomy has had favourable outcomes, it has also had many complications which were low among Minimally invasive procedures. This retrospective cohort analysis compares minimally invasive and open distal pancreatectomy (MIDP) outcomes using a national inpatient database.
Methods: The study used 2016-2020 NIS data. The study included 1577 distal pancreatic malignant tumor surgery patients. There were 530 Minimally Invasive and 1047 Open groups. Propensity matched analysis was performed on surgical groups to reduce confounding variables.
Results: In comparison to open procedures, minimally invasive techniques reduced hospital stays by 10 ​% (OR ​= ​0.90, 95 ​% CI 0.86-0.93). While not statistically significant, the unmatched analysis linked MIDP to lower in-hospital mortality. African Americans were 37 ​% less likely to undergo MIDP than Caucasians (OR ​= ​0.63, 95 ​% CI ​= ​0.40-0.96).
Conclusion: Nationwide analysis suggests MIDP may be a safe and effective surgical treatment for distal pancreatic adenocarcinoma. It may reduce hospital stays and mortality over open surgery. The study also suggests race may affect minimally invasive procedure rates.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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