Decreased Expression of Hepatic Signaling Phosphoproteins After Laparoscopic and Hand-Assisted Surgery in a Porcine Model

Gao, Yue; Qiao, Yi; Kreutzer, Donald L.; Novitsky, Yuri W.

doi:10.1016/j.jss.2011.09.051

Cited by 2 publications

(1 citation statement)

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“…12 Both animal and human studies have demonstrated that MIS is associated with both decreased inflammatory response and reduced immunosuppression. [13][14][15][16] While it is theorized that improved perioperative outcomes of MIS lead to sooner adjuvant therapy, studies have had conflicting results. 17,18 Despite the theoretical benefits of MIS LP, no studies have shown improved oncologic outcomes compared to open LP.…”

Section: Introductionmentioning

confidence: 99%

Improved oncologic outcomes for minimally invasive left pancreatectomy: Propensity‐score matched analysis of the National Cancer Database

Watson

Baimas-George

Thompson

et al. 2020

Journal of Surgical Oncology

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Background and objectives: Minimally invasive (MIS) left pancreatectomy (LP) is increasingly used to treat pancreatic adenocarcinoma (PDAC). Despite improved short-term outcomes, no studies have demonstrated long-term benefits over open resection. Methods: The National Cancer Database was queried between 2010 and 2016 for patients with PDAC, grouped by surgical approach (MIS vs open). Demographics, comorbidities, clinical staging, and pathologic staging were used for propensity-score matching. Perioperative, short-term oncologic, and survival outcomes were compared. Results: After matching, both cohorts included 805 patients. There were no differences in baseline characteristics, staging, or preoperative therapy between cohorts. The MIS cohort had a shorter length of stay (6.8 ± 5.5 vs 8.5 ± 7.3 days; P < .0001) with the trend toward improved time to chemotherapy (53.9 ± 26.1 vs 57.9 ± 29.9 days; P = .0511) and margin-positive resection rate (15.3% vs 18.9%; P = .0605). Lymph node retrieval and receipt of chemotherapy were similar. The MIS cohort had higher median overall survival (28.0 vs 22.1 months; P = .0067). Subgroup analysis demonstrated the highest survival for robotic compared with laparoscopic and open LP (41.9 vs 26.6 vs 22.1 months; P < .0001). Conclusions: This study demonstrates the safety of MIS LP and favorable long-term oncologic outcomes. The improved survival after MIS LP warrants further study with prospective, randomized trials.

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