Robotic and open distal pancreatectomy with celiac axis resection for locally advanced pancreatic body tumors: a single institutional assessment of perioperative outcomes and survival
Robotic and open distal pancreatectomy with celiac axis resection for locally advanced pancreatic body tumors: a single institutional assessment of perioperative outcomes and survival
复制标题
DOI：
10.1016/j.hpb.2016.05.003
复制
发表时间：
2016-10-01
期刊：
影响因子：
2.9
通讯作者：
Zureikat, Amer H.
中科院分区：
文献类型：
--
作者：
Ocuin, Lee M.;Miller-Ocuin, Jennifer L.;Zureikat, Amer H.
背景：远端胰腺切除术联合腹腔干切除术（DP-CAR）是治疗胰体T4肿瘤的一种选择。我们研究了开放式和机器人DP-CAR在高容量pancreatic center.Methods的围手术期和肿瘤结局：回顾性分析所有连续的DP-CAR。患者的人口统计学资料，90天围手术期的结果，和疾病特异性survival.Results：30 DP-CAR进行（11机器人，19开放）。两组术前/肿瘤特征相似，28例PDA患者中有27例接受了新辅助化疗。机器人DP-CAR与OT减少（316 vs. 476 min）、EBL减少（393 vs. 1736 ml）和输血率降低（0% vs. 54%）相关（所有p < 0.05）。无需机器人DP-CAR进行转换。两组的90天死亡率、主要发病率、LOS、再入院率和接受辅助治疗率相似。同样，两种入路的R 0切除率均较高（82% vs. 79%）。在中位随访33个月时，PDA队列的中位总生存期为35个月，机器人和开放式方法无差异（33和40个月，p = 0.310）。结论：中位生存期接近3年，DP-CAR代表了局部晚期胰腺癌患者的有效治疗方法，无论采用何种方法。
Background: Distal pancreatectomy with celiac axis resection (DP-CAR) is an option for T4 tumors of the pancreatic body. We examined the perioperative and oncologic outcomes of open and robotic DP-CAR at a high-volume pancreatic center.Methods: Retrospective review of all consecutive DP-CARs. Patient demographics, 90-day perioperative outcomes, and disease specific survival were collected.Results: 30 DP-CARs were performed (11 Robotic, 19 Open). Both groups had similar preoperative/tumor characteristics, and 27 of 28 PDA patients received neoadjuvant chemotherapy. Robotic DP-CAR was associated with decreased OT (316 vs. 476 min), reduced EBL (393 vs. 1736 ml) and lower rates of blood transfusion (0% vs. 54%) (all p < 0.05). No robotic DP-CAR required conversion. Both groups had similar rates of 90-day mortality, major morbidity, LOS, readmission, and receipt of adjuvant therapy. Similarly, both approaches were associated with high R0 resection rates (82% vs. 79%). At a median follow-up of 33 months, median overall survival for the PDA cohort was 35 months, with no difference in the robotic and open approach (33 and 40 months, p = 0.310).Conclusions: With a median survival approaching 3 years, DP-CAR represents an effective treatment for select patients with locally advanced pancreatic body cancer, regardless of approach.