A Systematic Review of Minimally Invasive Versus Open Radical Antegrade Modular Pancreatosplenectomy for Pancreatic Cancer

• Published in: Anticancer research Vol. 42; no. 2; pp. 653 - 660
• Main Authors: Takagi, Kosei, Umeda, Yuzo, Yoshida, Ryuichi, Yagi, Takahito, Fujiwara, Toshiyoshi
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.02.2022
• Subjects: Cancer; Humans; Lymph nodes; Metastases; Minimally Invasive Surgical Procedures; Pancreatectomy - mortality; Pancreatic cancer; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Splenectomy - mortality; Survival Rate; Treatment Outcome; radical antegrade modular pancreatosplenectomy; laparoscopic; pancreatic cancer; Distal pancreatectomy; robotic; review
• ISSN: 0250-7005; 1791-7530
• DOI: 10.21873/anticanres.15523

The aim of this study was to investigate surgical and oncological outcomes of minimally invasive (MI) and open radical antegrade modular pancreatosplenectomy (RAMPS) for the treatment of left-sided pancreatic cancer. A systematic literature search and meta-analyses were performed focusing on short-term surgical oncology of MI- and open-RAMPS. A total of seven studies with 423 patients were included in this review. The equivalent short-term and long-term outcomes of the groups were confirmed. The results of meta-analyses found no significant difference in R0 resection rates (OR=1.78, 95%CI=0.76-4.15, p=0.18), although MI-RAMPS was associated with a smaller number of dissected lymph nodes (MD=-3.14, 95%CI=-4.75 - -1.53, p<0.001) and lymph node metastases (OR=0.55, 95%CI=0.31-0.97, p=0.04). MI-RAMPS could provide surgically and oncologically feasible outcomes for well-selected left-sided pancreatic cancer as compared to open-RAMPS. However, further high-level evidence should be needed to confirm survival benefits following MI-RAMPS.