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01.12.2011 | Ausgabe 12/2011

World Journal of Surgery 12/2011

Robotic Versus Open Pancreaticoduodenectomy: A Comparative Study at a Single Institution

Zeitschrift:
World Journal of Surgery > Ausgabe 12/2011
Autoren:
Nicolas Christian Buchs, Pietro Addeo, Francesco Maria Bianco, Subhashini Ayloo, Enrico Benedetti, Pier Cristoforo Giulianotti
Wichtige Hinweise
This study was presented at the 2nd Worldwide Meeting of the Clinical Robotic Surgery Association (CRSA), Chicago, October 2, 2010.

Abstract

Background

Minimally invasive pancreaticoduodenectomy (PD) remains one of the most challenging abdominal procedures, and its application is poorly reported in the literature so far. To date, few data are available comparing a minimally invasive approach to open PD. The aim of the present study is to compare the robotic and open approaches for PD at a single institution.

Methods

Data from 83 consecutive PD procedures performed between January 2002 and May 2010 at a single institution were retrospectively reviewed. Patients were stratified into two groups: the open group (n = 39; 47%) and the robotic group (n = 44; 53%).

Results

Patients in the robotic group were statistically older (63 years of age versus 56 years; p = 0.04) and heavier (body mass index: 27.7 vs. 24.8; p = 0.01); and had a higher American Society of Anesthesiologists (ASA) score (2.5 vs. 2.15; p = 0.01) when compared to the open group. Indications for surgery were the same in both groups. The robotic group had a significantly shorter operative time (444 vs. 559 min; p = 0.0001), reduced blood loss (387 vs. 827 ml; p = 0.0001), and a higher number of lymph nodes harvested (16.8 vs. 11; p = 0.02) compared to the open group. There was no significant difference between the two groups in terms of complication rates, mortality rates, and hospital stay.

Conclusions

The authors present one of the first studies comparing open and robotic PD. While it is too early to draw definitive conclusions concerning the long-term outcomes, short-term results show a positive trend in favor of the robotic approach without compromising the oncological principles associated with the open approach.

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