Robotic pancreatic surgery: minimally invasive approach to challenging operations
| Autor: | Lapo Bencini, Irene Urciuoli, Martina Trafeli, Angela Tribuzi, Sabrina Pacciani, Luca Moraldi, A. Coratti, Claudia Paolini |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Population Enucleation Splenectomy Robotic Surgical Procedures Humans Medicine Robotic surgery education Pancreas Retrospective Studies education.field_of_study business.industry Incidence (epidemiology) Robotics Perioperative Pancreaticoduodenectomy Random Amplified Polymorphic DNA Technique Surgery Pancreatic Neoplasms medicine.anatomical_structure Laparoscopy business |
| Zdroj: | Minerva Surgery. 76 |
| ISSN: | 2724-5438 2724-5691 |
| Popis: | Background Pancreatic surgery is still associated with high perioperative morbidity and mortality. The purpose of this study was to present the short-term outcomes of robot-assisted pancreatic surgery, including pancreaticoduodenectomy (RAPD), distal pancreatectomy (RDP) with or without splenectomy, enucleation (REN), and atypical resection (RAR), for benign, borderline, and malignant lesions at a high-volume center. Methods A single-center, prospective database was used to retrospectively analyze the early outcomes of robotic pancreatic procedures completed between 2014 and 2020. Out of 124 attempted operations, 3 patients received palliative robotic surgery (2.4%). Of the remaining 121, 14 (11.6%) were converted to open surgery. The robotic procedures included 107 patients: 56 underwent RAPD, 31 underwent RDP (28 with and 3 without splenectomy), 16 underwent REN, and 4 underwent RAR (2 central and 2 total pancreatectomies). Results The preoperative baseline characteristics and comorbidities were consistent with those of a Western population. The overall incidence of complications was 43.9%, with the more severe (Clavien-Dindo III-IV) occurring after RAPD (19.6%). We collected 7 (13.1%) postoperative pancreatic fistulae after RAPD, 5 (16.1%) after RADP, and 2 (12.5%) after REN. The two central pancreatectomies developed a biochemical leak without sequelae. Three patients (2.8%) died within 90 days after surgery. Early refeeding was achieved in those who did not experience severe complications, while the median hospital stay was 8 days. The median number of harvested lymph nodes was 22, with non-R1 microscopic residual tumors found. Conclusions Robotic pancreatic surgery is a safe and oncologically adequate technique to manage benign and malignant diseases arising from the head, body, and tail of the pancreas. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|