Comparison of Short-Term Outcomes Between Robotic-Assisted and Open Pancreatoduodenectomy: A Retrospective Cohort Study With Inverse Probability of Treatment Weighting (IPTW) Analysis

IF 2.3 3区 医学 Q2 SURGERY
Xi-Tai Huang, Jin-Zhao Xie, Jian-Peng Cai, Qiong-Cong Xu, Wei Chen, Chen-Song Huang, Bin Li, Jia-Ming Lai, Li-Jian Liang, Xiao-Yu Yin
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引用次数: 0

Abstract

Background

The advantages of robotic-assisted pancreatoduodenectomy (RPD) in comparison with open pancreatoduodenectomy (OPD) have not been well-established. We aimed to compare their short-term outcomes by inverse probability of treatment weighting (IPTW) analysis.

Methods

Patients who underwent RPD/OPD at our hospital were recruited. Stabilised IPTW were performed to adjust observed covariates. Short-term outcomes were compared.

Results

After IPTW, the effective sample comprised 807 patients (199 RPD, 608 OPD) with balanced clinicopathological characteristics. RPD had a longer operation time, fewer intraoperative blood loss (IBL), and lower blood transfusion rate than OPD. RPD was associated with a lower incidence of clinically relevant postoperative pancreatic fistula and reoperation but did not reach statistical significance. In pancreatic adenocarcinoma, RPD had a significantly higher number of lymph nodes examined. There were no significant differences in postoperative morbidities and length-of-stay.

Conclusions

RPD was associated with fewer IBL and transfusion rates than OPD. RPD can be considered feasible and safe.

机器人辅助胰十二指肠切除术与开放式胰十二指肠切除术的短期疗效比较:一项治疗加权逆概率(IPTW)分析的回顾性队列研究
与开放式胰十二指肠切除术(OPD)相比,机器人辅助胰十二指肠切除术(RPD)的优势尚未得到证实。我们的目的是通过治疗加权逆概率(IPTW)分析比较他们的短期结果。方法选取我院接受RPD/OPD治疗的患者。采用稳定IPTW来调整观察到的协变量。比较短期结果。结果IPTW后有效样本共807例(RPD 199例,OPD 608例),临床病理特征平衡。与OPD相比,RPD手术时间更长,术中出血量(IBL)少,输血率低。RPD与临床相关的术后胰瘘发生率及再手术发生率较低相关,但无统计学意义。在胰腺腺癌中,RPD检查的淋巴结数量明显增加。两组术后发病率和住院时间无显著差异。结论与OPD相比,RPD的IBL和输血率较低。RPD可以被认为是可行和安全的。
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来源期刊
CiteScore
4.50
自引率
12.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.
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