Evaluation of feasibility and clinical outcomes of robot-assisted pancreaticoduodenectomy after neoadjuvant treatment for patients with advanced pancreatic ductal adenocarcinoma: a retrospective propensity score-matched cohort study.

IF 1.6 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2025-08-01 Epub Date: 2025-07-30 DOI:10.4174/astr.2025.109.2.61

Ha Eun Kim, Hye-Sol Jung, Youngmin Han, Yoon Soo Chae, Won-Gun Yun, Young Jae Cho, Wooil Kwon, Joon Seong Park, Jin-Young Jang

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Abstract

Purpose: With neoadjuvant treatment (NAT) broadening the surgical indication for advanced pancreatic cancer, the growing use of robotic platforms in pancreaticoduodenectomy (PD) necessitates the evaluation of its feasibility in advanced pancreatic cancer patients who have undergone NAT.

Methods: We compared clinicopathological outcomes of advanced pancreatic cancer patients who received either robot-assisted or open PD after NAT at a tertiary hospital from 2015 to 2023. Propensity score matching was performed based on age, sex, and TNM staging.

Results: Among 223 patients who received conversion surgery after NAT, 42 open PD and 14 robot-assisted PD patients were matched in a 3:1 ratio. There was a trend of shorter hospital stays (11.4 days vs. 9.8 days, P = 0.218) and less severe postoperative complications (21.4% vs. 7.1%; P = 0.227) in the robot-assisted PD group. Lymph node (LN) yield, LN metastasis rate, and R0 resection rates were similar between the 2 groups. The overall (OS) and disease-free survival (DFS) rates between the 2 groups were comparable (5-year OS rate: 55.7% vs. 72.7%, P = 0.264; 5-year DFS rate: 54.4% vs. 58.4%, P = 0.759).

Conclusion: Robot-assisted PD offers comparable short-term and long-term outcomes to open PD, even in patients undergoing conversion surgery after NAT.

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评估晚期胰管腺癌患者新辅助治疗后机器人辅助胰十二指肠切除术的可行性和临床结果：回顾性倾向评分匹配队列研究

目的：随着新辅助治疗（NAT）拓宽了晚期胰腺癌的手术指征，机器人平台在胰十二指肠切除术（PD）中的应用越来越多，有必要对其在接受过NAT的晚期胰腺癌患者中的可行性进行评估。方法：我们比较2015年至2023年在某三级医院接受NAT后机器人辅助或开放式PD的晚期胰腺癌患者的临床病理结果。根据年龄、性别和TNM分期进行倾向评分匹配。结果：223例NAT术后转换手术患者中，开放PD 42例，机器人辅助PD 14例，比例为3:1。住院时间缩短（11.4天比9.8天，P = 0.218），术后并发症减少(21.4%比7.1%；P = 0.227)。两组间淋巴结（LN）产出率、淋巴结转移率、R0切除率相似。两组的总生存率（OS）和无病生存率（DFS）具有可比性(5年生存率：55.7% vs. 72.7%, P = 0.264；5年DFS率：54.4% vs. 58.4%, P = 0.759)。结论：机器人辅助PD的短期和长期效果与开放式PD相当，即使在NAT后接受转换手术的患者中也是如此。

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

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).