Current landscape of minimally invasive pancreatectomy for neoplasms: A retrospective cohort study.

IF 2.3 3区医学 Q2 SURGERY

World Journal of Surgery Pub Date : 2024-11-22 DOI:10.1002/wjs.12408

Rejoice F Ngongoni, Busisiwe Mlambo, I-Fan Shih, Yanli Li, Sherry M Wren

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引用次数: 0

Abstract

Background: To evaluate recent minimally invasive pancreatectomy (MIP) trends for neoplastic disease and compare perioperative outcomes.

Methods: Patients who underwent open (OS) or MIP (laparoscopic-LS or robotic-RS) pancreaticoduodenectomy (PD) or non-pancreati-coduodenectomy resections (non-PD) were identified from PINC AI Healthcare Database. Outcomes were compared using multivariable regressions.

Results: OS was the predominant approach for PD (87.8%); MIP was more common in non-PD (48.5%) than PD with a substantial RS uptake (11.7%-29.9%). In PDs, outcomes were similar except OS had a longer length of stay (LOS) and lower costs. In non-PDs, MIP patients were less likely to have prolonged LOS, intensive care unit admission, and overall complications than OS. Conversion to OS was lower in the RS approach than LS in PD and non-PD.

Conclusions: MIP for non-PD has become the most common operative approach with improved outcomes; MIP-PD has flat adoption and similar outcomes to OS. Robotics facilitates MIP (PD and non-PD) completion through fewer conversions to open surgery (OS).

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微创胰腺切除术治疗肿瘤的现状：回顾性队列研究

背景：评估肿瘤性疾病微创胰腺切除术（MIP）的最新趋势并比较围手术期的结果：评估近期肿瘤性疾病微创胰腺切除术（MIP）的发展趋势，并比较围手术期的结果：方法：从 PINC AI 医疗数据库中找出接受开腹（OS）或微创（腹腔镜-LS 或机器人-RS）胰十二指肠切除术（PD）或非胰十二指肠切除术（non-PD）的患者。采用多变量回归对结果进行比较：OS是腹部切除术的主要方法（87.8%）；MIP在非腹部切除术中更为常见（48.5%），而在腹部切除术中RS的使用率较高（11.7%-29.9%）。除了 OS 的住院时间（LOS）更长、费用更低之外，PDs 的治疗结果相似。在非肺结核患者中，MIP患者的住院时间延长、入住重症监护室和出现总体并发症的几率低于OS患者。在肺结核和非肺结核患者中，RS方法转为OS的比例低于LS方法：结论：MIP治疗非PD已成为最常见的手术方法，并改善了治疗效果；MIP-PD的采用率持平，治疗效果与OS相似。机器人技术通过减少向开放手术（OS）的转换，促进了MIP（PD和非PD）的完成。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Surgery 医学-外科

CiteScore

5.10

自引率

3.80%

发文量

460

审稿时长

3 months

期刊介绍： World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.