Oncologic outcomes after robot‐assisted versus laparoscopic distal pancreatectomy: Analysis of the National Cancer Database

Raoof, Mustafa; Nota, C.; Melstrom, Laleh G.; Warner, Susanne G.; Woo, Yanghee; Singh, Gagandeep; Fong, Yuman

doi:10.1002/jso.25170

Cited by 58 publications

(52 citation statements)

References 24 publications

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“…Considering our short follow-up (2 years) and the small sample size, it is not possible to draw strong conclusions in terms of long-term disease-free and overall survival but until now we observed a similar recurrence rate in the laparoscopic versus robotic group (4/20 vs. 4/21) as recently reported by a National Cancer Database involving 704 patients [50].…”

Section: Discussionsupporting

confidence: 66%

Robotic-Assisted versus Laparoscopic Distal Pancreatectomy: The Results of a Case-Matched Analysis from a Tertiary Care Center

et al. 2019

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Background: Laparoscopic distal pancreatectomy (LDP) has been adopted relatively slowly despite the benefits of minimally invasive approach. The robotic approach can overcome the limitations of LDP, thus increasing the acceptance of minimally invasive distal pancreatectomy. Methods: We performed a 1: 1 retrospective case-matched comparison among 2 groups of 35 patients who underwent robotic-assisted distal pancreatectomy (RDP) or LDP from August 2014 to April 2017. Results: The operative time was similar in both groups (230 RDP vs. 205 LDP min, p = 0.382). The robotic group had a lower estimated blood loss (95 vs. 275 mL, p = 0.035). The spleen preservation rate was higher in the RDP group (100 vs. 66.7%, p = 0.027), while the conversion rate to open surgery was higher in the laparoscopic group (14.3 vs. 2.9%, p = 0.048). The overall complication rate was lower in the robotic group (25.7 vs. 37.1%, p = 0.044). There was no statistically significant difference in oncologic outcomes between the groups in terms of R0 resection rate (100% RDP vs. 85% LDP, p = 0.233) and number of harvested lymph nodes (14.4 RDP vs. 10.8 LDP, p = 0.678). Conclusions: The RDP showed a lower estimated blood loss, conversion, and morbidity rate. It offered a higher spleen preservation rate in comparison to LDP while maintaining comparable oncologic outcomes.

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Section: Discussionsupporting

confidence: 66%

Robotic-Assisted versus Laparoscopic Distal Pancreatectomy: The Results of a Case-Matched Analysis from a Tertiary Care Center

et al. 2019

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“…This study did not aim to assess the if and what the MIS approach was safe or appropriate. A recent report from the National Cancer Data Base comparing laparoscopic and robotic distal pancreatectomy had similar short‐term outcomes including length of hospital stay and 30‐day readmission rate, as well as similar long‐term oncologic outcomes including overall survival 6 . Rather, our study aimed to review granular data as it pertains to cost with the various operative approaches to distal pancreatectomy.…”

Section: Discussionmentioning

confidence: 98%

“…A recent report from the National Cancer Data Base comparing laparoscopic and robotic distal pancreatectomy had similar short-term outcomes including length of hospital stay and 30-day readmission rate, as well as similar long-term oncologic outcomes including overall survival. 6 Rather, our study aimed to review granular data as it pertains to cost with the various operative approaches to distal pancreatectomy. We were unable to adequately compare the cost of conversion for laparoscopic and robotic procedures due to the low number of converted laparoscopic procedures (n = 3) in our cohort, but it was clear that robotic surgery had the highest operating room costs.…”

Section: Cost Comparisonmentioning

confidence: 99%

Minimally invasive distal pancreatectomy and the cost of conversion

Stewart

Wong

Selby

et al. 2020

Journal of Surgical Oncology

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Background Minimally invasive surgery (MIS) is preferred for distal pancreatectomy but is not always attempted due to the risk of conversion to open. We hypothesized that the total cost for MIS converted to open procedures would be comparable to those that started open. Methods A prospectively collected institutional registry (2011‐2017) was reviewed for demographic, clinical, and perioperative cost data for patients undergoing distal pancreatectomy. Results There were 80 patients who underwent distal pancreatectomy: 41 open, 39 MIS (11 laparoscopic and 28 robotic). Conversion to open occurred in 14 of 39 (36%, 3 laparoscopic and 11 robotic). Length of stay was shorter for the MIS completed (6 days; range, 3‐8), and MIS converted to open (7 days; range, 4‐10) groups, compared with open (10 days; range, 5‐36; P = .003). Laparoscopic cases were the least expensive (P = .02). Robotic converted to open procedures had the highest operating room cost. However, the total cost for robotic converted to open cohort was similar to the open cohort due to cost savings associated with a shorter length of stay. Conclusions Despite the higher intraoperative costs of robotic surgery, there is no significant overall financial penalty for conversion to open. Financial considerations should not play a role in selecting a robotic or open approach.

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“…Another prospective study compared robotic with laparoscopic single-site distal pancreatectomy and found longer operative time for the robotic approach, while postoperative and oncologic outcomes were similar [35]. In contrast, analysis of the US NCDB demonstrated comparable oncologic outcomes, but a higher conversion rate for laparoscopic distal pancreatectomy [36].…”

Section: Laparoscopic Versus Robotic Distal Pancreatectomymentioning

confidence: 99%

Minimally invasive pancreatic surgery—where are we going?

et al. 2019

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Background Introduced in the mid-1990s, minimally invasive pancreatic surgery (MIPS) developed slowly over the next two decades, and its real-life benefits remained unclear. Methods In this review, the current status and evidence on the most common types of MIPS, such as minimally invasive pancreatoduodenectomy (MIPD), distal pancreatectomy, enucleation, and central pancreatectomy are presented. Results Minimally invasive distal pancreatectomy (MIDP) is the most frequently used procedure among

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Oncologic outcomes after robot‐assisted versus laparoscopic distal pancreatectomy: Analysis of the National Cancer Database

Abstract: The early national experience with RDP demonstrates similar oncologic outcomes to LDP, with a significantly lower conversion rate.

Cited by 58 publications

References 24 publications

Robotic-Assisted versus Laparoscopic Distal Pancreatectomy: The Results of a Case-Matched Analysis from a Tertiary Care Center

Robotic-Assisted versus Laparoscopic Distal Pancreatectomy: The Results of a Case-Matched Analysis from a Tertiary Care Center

Minimally invasive distal pancreatectomy and the cost of conversion

Minimally invasive pancreatic surgery—where are we going?

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