Outcomes After Minimally Invasive Versus Open Total Pancreatectomy: A Pan-European Propensity Score Matched Study
| Autor: | Carlo Lombardo, Mohammed Abu Hilal, Tobias Keck, Igor Khatkov, P. Tyutyunnik, David Fuks, Lianne Scholten, Niccolò Napoli, Alberto Manzoni, Gianpaolo Balzano, Sjors Klompmaker, Jony van Hilst, Fernando Burdío, Edoardo Rosso, Giovanni Ferrari, Riccardo Casadei, Mario Annecchiarico, Mustafa Kerem, Massimo Falconi, Marc G. Besselink, Jean-Michel Fabre, Ulrich F. Wellner, Michele Mazzola, Ugo Boggi |
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| Přispěvatelé: | Surgery, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Scholten, Lianne, Klompmaker, Sjor, Van Hilst, Jony, Annecchiarico, Mario M, Balzano, Gianpaolo, Casadei, Riccardo, Fabre, Jean-Michel, Falconi, Massimo, Ferrari, Giovanni, Kerem, Mustafa, Khatkov, Igor E, Lombardo, Carlo, Manzoni, Alberto, Mazzola, Michele, Napoli, Niccolò, Rosso, Edoardo E, Tyutyunnik, Pavel, Wellner, Ulrich F, Fuks, David, Burdio, Fernando, Keck, Tobia, Hilal, Mohammed Abu, Besselink, Marc G, Boggi, Ugo |
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
medicine.medical_specialty
robot-assisted surgery Adult patients propensity score matching business.industry Total pancreatectomy laparoscopic surgery Pancreatic surgery Primary outcome Pan european Internal medicine Propensity score matching total pancreatectomy minimally invasive surgery laparoscopic surgery robot-assisted surgery pancreatic surgery propensity score matching Overall survival Medicine Surgery total pancreatectomy pancreatic surgery business Hospital stay minimally invasive surgery |
| Zdroj: | Annals of surgery, 277(2), 313-320. Lippincott Williams and Wilkins |
| ISSN: | 0003-4932 |
| Popis: | © 2022 Wolters Kluwer Health, Inc. All rights reserved.Objective: To assess postoperative 90-day outcomes after minimally invasive (laparoscopic/robot-assisted) total pancreatectomy (MITP) in selected patients versus open total pancreatectomy (OTP) among European centers. Background: Minimally invasive pancreatic surgery is becoming increasingly popular but data on MITP are scarce and multicenter studies comparing outcomes versus OTP are lacking. It therefore remains unclear if MITP is a valid alternative. Methods: Multicenter retrospective propensity-score matched study including consecutive adult patients undergoing MITP or OTP for all indications at 16 European centers in 7 countries (2008-2017). Patients after MITP were matched (1:1, caliper 0.02) to OTP controls. Missing data were imputed. The primary outcome was 90-day major morbidity (Clavien-Dindo ≥3a). Secondary outcomes included 90-day mortality, length of hospital stay, and survival. Results: Of 361 patients (99MITP/262 OTP), 70 MITP procedures (50 laparoscopic, 15 robotic, 5 hybrid) could be matched to 70 OTP controls. After matching, MITP was associated with a lower rate of major morbidity (17% MITP vs. 31% OTP, P = 0.022). The 90-day mortality (1.4% MITP vs. 7.1% OTP, P = 0.209) and median hospital stay (17 [IQR 11-24] MITP vs. 12 [10-23] days OTP, P = 0.876) did not differ significantly. Among 81 patients with PDAC, overall survival was 3.7 (IQR 1.7-N/A) versus 0.9 (IQR 0.5-N/ A) years, for MITP versus OTP, which was nonsignificant after stratification by T-stage. Conclusion: This international propensity score matched study showed that MITP may be a valuable alternative to OTP in selected patients, given the associated lower rate of major morbidity. |
| Databáze: | OpenAIRE |
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