A propensity score-matched analysis of robotic versus open pancreatoduodenectomy for pancreatic cancer based on margin status

Kauffmann, Emanuele Federico; Napoli, Niccolò; Menonna, Francesca; Iacopi, Sara; Lombardo, Carlo; Bernardini, Juri; Amorese, G; Insilla, Andrea Cacciato; Funel, Niccola; Campani, Daniela; Cappelli, Carla; Caramella, Davide; Boggi, Ugo

doi:10.1007/s00464-018-6301-2

Cited by 40 publications

(29 citation statements)

References 38 publications

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“…After sensitivity analysis, the meta-results did not show any reversal changes. However, when Cai et al [14] was eliminated, the heterogeneity was signi cantly reduced (I 2 = 0%, P = 0.43), the xed-effects model yielded an RR of 0.65, 95%CI (0.50, 0.86), P = 0.002, and the statistically signi cant difference remained. In both retrospective and prospective cohort studies, there was a statistically signi cant difference in the number of transfusion between the RPD group and the OPD group (RR = 0.69, 95% CI: 0.48, 0.99, P = 0.04; RR = 0.48, 95% CI: 0.31, 0.75, P = 0.001, respectively) (Figs.…”

Section: Comparison Of Intraoperative Blood Transfusionmentioning

confidence: 95%

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Safety and efficacy of robot-assisted versus open pancreaticoduodenectomy: a meta-analysis of multiple worldwide centers

et al. 2020

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Objectives: To compare the e cacy of robot-assisted pancreaticoduodenectomy with that of laparotomy. Methods: The PubMed, EMBASE, Cochrane Library, and other databases were searched for literature available from their respective inception dates up to May 2020 to nd studies comparing robot-assisted pancreaticoduodenectomy (RPD) with open pancreaticoduodenectomy (OPD). The RevMan 5.3 statistical software was used for analysis to evaluate surgical outcome and oncology safety. The combination ratio (RR) and weighted mean difference (WMD) and their 95% con dence intervals (CIs) were calculated using xed effect or random effect models. Results: 18 cohort studies from 16 medical centers were eligible with a total of 5795 patients including 1420 RPD group patients and 4375 OPD group patients. The RPD group fared better than the OPD group in terms of estimated blood loss (EBL) (WMD =-175.

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Section: Comparison Of Intraoperative Blood Transfusionmentioning

confidence: 95%

“…Six studies [10,13,14,19,20,23] reported the severe complication. There was a low degree of heterogeneity (I 2 = 0%, P = 0.89) among the studies.…”

Section: Severe Complicationmentioning

confidence: 99%

Safety and efficacy of robot-assisted versus open pancreaticoduodenectomy: a meta-analysis of multiple worldwide centers

et al. 2020

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“…A review of our own experience revealed longer operative times of approximately 136 min when compared with our open PD cohort [14] . However, robotic PD resulted in less blood loss (200 mL lower), a shorter intensive care unit stay, a lower 30-day complication rate, and no difference in total costs compared with open PD [15,16] .…”

Section: Discussionmentioning

confidence: 75%

“…Multiple single or multi-institutional retrospective studies to compare specific outcomes between robotic, laparoscopic and open approaches are reported [6,[14][15][16][18][19][20][21][22][23][24] . A large systematic review examined data from 13 retrospective series [25] .…”

Section: Discussionmentioning

confidence: 99%

Robotic pancreaticoduodenectomy and splenopancreatectomy: technical aspects and review of literature

Tschuor¹,

Nagarkatti²,

Salibi³

et al. 2020

Mini-invasive Surg

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Robotic pancreatic surgery provides several advantages. Since the first report of a robotic-assisted distal pancreatectomy in 2001, total pancreatectomies, pancreatic tumor enucleations, pancreaticoduodenectomy, central pancreatectomy and Appleby procedures have been performed, indicating a promising future. The aim of this article is to describe our experience of robotic pancreatic surgery including technical aspects for pancreaticoduodenectomy and distal pancreatectomy. The current literature on feasibility, safety and early postoperative outcomes will be discussed.

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“…Twenty-four studies were included in the final quantitative data synthesis, totaling 12,579 patients (2,175 robotic PD and 10,404 open PD) 8,28,30, . Seven studies 30,34,36,38,41,50,52 were prospective cohort studies and 17 retrospective cohort studies 8,28,35,37,39,40,[42][43][44][45][46][47][48][49]51,53,54 . In four of these studies 34,40,43,50 , data were extracted from the abstracts of conference proceedings published in indexed journals.…”

Section: Discussionmentioning

confidence: 99%

Robotic pancreaticoduodenectomy provides better histopathological outcomes as compared to its open counterpart: a meta-analysis

Dong

Felsenreich

Gogna

et al. 2021

Sci Rep

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The aim of this meta-analysis was to evaluate whether robotic pancreaticoduodenectomy (PD) may provide better clinical and pathologic outcomes compared to its open counterpart. The Pubmed, EMBASE, and Cochrane Library were systematically searched. Overall postoperative morbidity and resection margin involvement rate were the primary endpoints. Secondary endpoints included operating time, estimated blood loss (EBL), incisional surgical site infection (SSI) rate, length of hospital stay (LOS), and number of lymph nodes harvested. Twenty-four studies totaling 12,579 patients (2,175 robotic PD and 10,404 open PD were included. Overall postoperative mortality did not significantly differ [OR (95%CI) = 0.86 (0.74, 1.01); p = 0.06]. Resection margin involvement rate was significantly lower in robotic PD [15.6% vs. 19.9%; OR (95%CI) = 0.64 (0.41, 1.00); p = 0.05; NNT = 23]. Operating time was significantly longer in robotic PD [MD (95%CI) = 75.17 (48.05, 102.28); p < 0.00001]. EBL was significantly decreased in robotic PD [MD (95%CI) = − 191.35 (− 238.12, − 144.59); p < 0.00001]. Number of lymph nodes harvested was significantly higher in robotic PD [MD (95%CI) = 2.88 (1.12, 4.65); p = 0.001]. This meta-analysis found that robotic PD provides better histopathological outcomes as compared to open PD at the cost of longer operating time. Furthermore, robotic PD did not have any detrimental impact on clinical outcomes, with lower wound infection rates.

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A propensity score-matched analysis of robotic versus open pancreatoduodenectomy for pancreatic cancer based on margin status

Cited by 40 publications

References 38 publications

Safety and efficacy of robot-assisted versus open pancreaticoduodenectomy: a meta-analysis of multiple worldwide centers

Safety and efficacy of robot-assisted versus open pancreaticoduodenectomy: a meta-analysis of multiple worldwide centers

Robotic pancreaticoduodenectomy and splenopancreatectomy: technical aspects and review of literature

Robotic pancreaticoduodenectomy provides better histopathological outcomes as compared to its open counterpart: a meta-analysis

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