Laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: oncologic outcomes and long-term survival
Autor: | Yi-Ping Mou, Yuanyu Wang, Ke Chen, Weiwei Jin, Nan Niu, Chao Lu, Yu-Cheng Zhou, Qicong Zhu, Zheling Chen |
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Rok vydání: | 2019 |
Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Adenocarcinoma Malignancy Gastroenterology Pancreaticoduodenectomy 03 medical and health sciences 0302 clinical medicine Internal medicine Pancreatic cancer medicine Humans Retrospective Studies business.industry Perioperative Hepatology medicine.disease Survival Analysis 030220 oncology & carcinogenesis Meta-analysis Female Laparoscopy 030211 gastroenterology & hepatology Surgery business Carcinoma Pancreatic Ductal Abdominal surgery Cohort study |
Zdroj: | Surgical Endoscopy. 34:1948-1958 |
ISSN: | 1432-2218 0930-2794 |
Popis: | The study aimed to compare the oncologic outcomes and long-term survival of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) for patients diagnosed with pancreatic ductal adenocarcinoma (PDAC). Substantial evidence demonstrated that LPD is technically safe and feasible with perioperative outcomes equivalent to that of OPD. However, for patients with malignancy, especially PDAC, the oncologic outcomes and long-term survival of patients who underwent LPD remains to be elucidated. Studies on LPD for the treatment of PDAC published before December 25, 2018 were searched online. The oncologic outcomes (e.g., numbers of lymph nodes retrieved, negative margin (R0) resection), and long-term survival (postoperative survival from 1 to 5 year) of LPD were compared to that of ODP. After screening 1507 studies, six comparative cohort studies, which reported the oncologic outcomes and long-term survival of patients with PDAC were included. No significant difference was found between LPD and OPD regarding lymph nodes harvested (OR 1.96, 95% CI − 1.17 to 5.09, p = 0.22), R0 rate (OR 1.44, 95% CI 1.00 to 2.06, p = 0.05), number of positive lymph nodes (OR − 0.44, 95% CI − 1.06 to 0.17, p = 0.16), rate of adjuvant treatment (OR 1.04, 95% CI 0.68 to 1.59, p = 0.86) and time to adjuvant treatment (OR − 6.21, 95% CI − 16.00 to 3.59, p = 0.21). LPD showed similar 1-year (OR 1.20, 95% CI 0.87 to 1.65, p = 0.28), and 2-year survival (OR 1.25, 95% CI 0.94 to 1.66, p = 0.13) to that of OPD. The 3-year (OR 1.50, 95% CI 1.12 to 2.02, p = 0.007), 4-year (OR 1.73, 95% CI 1.02 to 2.93, p = 0.04), and 5-year survival (OR 2.11, 95% CI 1.35 to 3.31, p = 0.001) were significantly longer in LPD group. For the treatment of PDAC, the oncologic outcomes of LPD were equivalent to that of OPD; LPD seemed promising regarding the postoperative long-term survival. |
Databáze: | OpenAIRE |
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