Robotic versus laparoscopic distal pancreatectomy: A propensity score‐matched study

• Published in: Journal of surgical oncology Vol. 116; no. 4; pp. 461 - 469
• Main Authors: Liu, Rong, Liu, Qu, Zhao, Zhi‐Ming, Tan, Xiang‐Long, Gao, Yuan‐Xing, Zhao, Guo‐Dong
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 15.09.2017
• Subjects: Blood Loss, Surgical - statistics & numerical data; Blood Transfusion - statistics & numerical data; Cancer surgery; China - epidemiology; conversion rate; Conversion to Open Surgery - statistics & numerical data; Humans; laparoscopic distal pancreatectomy; Laparoscopy; Length of Stay - statistics & numerical data; Male; Matched-Pair Analysis; Middle Aged; minimally invasive surgery; Operative Time; Organ Sparing Treatments; Pancreatectomy; Pancreatectomy - methods; Pancreatic Fistula - epidemiology; Pancreatic Neoplasms - surgery; Propensity Score; robotic distal pancreatectomy; Robotic Surgical Procedures; Robotics; Spleen; spleen preservation; laparoscopic distal pancreatectomy; spleen preservation; robotic distal pancreatectomy; minimally invasive surgery; conversion rate
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.24676

Background Robotic distal pancreatectomy (RDP) is considered a safe and feasible alternative to laparoscopic distal pancreatectomy (LDP). However, previous studies have some limitations including small sample size and selection bias. This study aimed to evaluate whether the robotic approach has advantages over laparoscopic surgery in distal pancreatectomy. Methods Demographics and perioperative outcomes among patients undergoing RDP (n = 102) and LDP (n = 102) between January 2011 and December 2015 were reviewed. A 1:1 propensity score matched analysis was performed between both groups. Results Both groups displayed no significant differences in perioperative outcomes including operative time, blood loss, transfusion rate, and rates of overall morbidities and pancreatic fistula. Robotic approach reduced the rate of conversion to laparotomy (2.9% vs 9.8%, P = 0.045), especially in patients with large tumors (0% vs 22.2%, P = 0.042). RDP improved spleen (SP) and splenic vessels preservation (SVP) rates in patients with moderate tumors (60.0% vs 35.5%, P = 0.047; 37.1% vs 12.9%, P = 0.025), especially in patients without malignancy (95.5% vs 52.4%, P = 0.001; 59.1% vs 19.0%, P = 0.007). RDP also reduced postoperative hospital stay (PHS) significantly (7.67% vs 8.58, P = 0.032). Conclusions RDP is associated with less rate of conversion to laparotomy, shorter PHS, and improved SP and SVP rates in selected patients than LDP.