Propensity‐Score Matched Analyses Comparing Clinical Outcomes of Minimally Invasive Versus Open Distal Pancreatectomies: A Single‐Center Experience

Raghupathy, Jaivikash; Lee, Chuan-Yaw; Huan, Sarah K. W.; Koh, Ye‐Xin; Tan, Ek Khoon; Teo, Jin‐Yao; Cheow, Peng‐Chung; Ooi, London L P J; Chung, Alexander Y. F.; Chan, Chung‐Yip; Goh, Brian K. P.

doi:10.1007/s00268-021-06306-x

Cited by 4 publications

(1 citation statement)

References 46 publications

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“…The surgical outcomes and oncological safety of open and MIS procedures are of great interest among pancreatic surgeons. On the one hand, MIS is considered to result in less pain and shortened recovery time for the following anti-cancer treatments ( 13 , 14 ). On the other hand, some malignant pancreatic cancer removals, such as RAMPS particularly, often have expanded surgical areas with the potential of more aggressive resection ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

The effect of minimally invasive or open radical antegrade modular pancreatosplenectomy on pancreatic cancer: A multicenter randomized clinical trial protocol

Dai

Zhang²,

Yang³

et al. 2022

Front. Oncol.

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BackgroundRadical antegrade modular pancreatosplenectomy (RAMPS) has been proven to improve R0 resection and lymph harvest in treating patients with distal pancreatic cancer. The development of minimally invasive surgery has advantages in postoperative recovery. Therefore, minimally invasive (MI-) RAMPS may combine the advantages of both benefits to improve survival. Nevertheless, evidence to validate the safety and efficacy of MI-RAMPS is limited.Method/DesignThe MIRROR trial will be the first multicenter prospective randomized clinical trial to investigate the outcome of MI-RAMPS. The hypothesis is that MI-RAMPS is superior in postoperative recovery. The primary outcome is the length of postoperative stay. Based on the hypothesis and primary outcome, the sample size is 250 patients (125 participants in each group). The trial will investigate factors related to surgical safety, short-term outcome, pathological assessment, and survival as secondary outcomes.ConclusionThis study will offer a relatively higher level of evidence to further illustrate the accessibility and benefits of MI-RAMPS for the treatment of distal pancreatic cancer.Clinical Trial RegistrationClinicaltrials.gov, NCT03770559.

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Section: Introductionmentioning

confidence: 99%

The effect of minimally invasive or open radical antegrade modular pancreatosplenectomy on pancreatic cancer: A multicenter randomized clinical trial protocol

Dai

Zhang²,

Yang³

et al. 2022

Front. Oncol.

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Robotic versus laparoscopic distal pancreatectomy on perioperative outcomes: a systematic review and meta-analysis

Zhang

Chen

et al. 2022

Updates Surg

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Robotic surgery has become a promising surgical method in minimally invasive pancreatic surgery due to its three-dimensional visualization, tremor filtration, motion scaling, and better ergonomics. Numerous studies have explored the benefits of RDP over LDP in terms of perioperative safety and feasibility, but no consensus has been achieved yet. This article aimed to evaluate the benefits and drawbacks of RDP and LDP for perioperative outcomes. By June 2022, all studies comparing RDP to LDP in the PubMed, the Embase, and the Cochrane Library database were systematically reviewed. According to the heterogeneity, fix or random-effects models were used for the meta-analysis of perioperative outcomes. Odds ratio (OR), weighted mean differences (WMD), and 95% confidence intervals (CI) were calculated. A sensitivity analysis was performed to explore potential sources of high heterogeneity and a trim and fill analysis was used to evaluate the impact of publication bias on the pooled results. Thirty-four studies met the inclusion criteria. RDP provides greater benefit than LDP for higher spleen preservation (OR 3.52 95% CI 2.62–4.73, p < 0.0001) and Kimura method (OR 1.93, 95% CI 1.42–2.62, p < 0.0001) in benign and low-grade malignant tumors. RDP is associated with lower conversion to laparotomy (OR 0.41, 95% CI 0.33–0.52, p < 0.00001), and shorter postoperative hospital stay (WMD − 0.57, 95% CI − 0.92 to − 0.21, p = 0.002), but it is more costly. In terms of postoperative complications, there was no difference between RDP and LDP except for 30-day mortality (RDP versus LDP, 0.1% versus 1.0%, p = 0.03). With the exception of its high cost, RDP appears to outperform LDP on perioperative outcomes and is technologically feasible and safe. High-quality prospective randomized controlled trials are advised for further confirmation as the quality of the evidence now is not high.

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Advantages of laparoscopic distal pancreatectomy: Systematic review and meta-analysis of randomized and matched studies

Cucchetti¹,

Bocchino²,

Crippa³

et al. 2023

Surgery

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Propensity‐Score Matched Analyses Comparing Clinical Outcomes of Minimally Invasive Versus Open Distal Pancreatectomies: A Single‐Center Experience

Cited by 4 publications

References 46 publications

The effect of minimally invasive or open radical antegrade modular pancreatosplenectomy on pancreatic cancer: A multicenter randomized clinical trial protocol

The effect of minimally invasive or open radical antegrade modular pancreatosplenectomy on pancreatic cancer: A multicenter randomized clinical trial protocol

Robotic versus laparoscopic distal pancreatectomy on perioperative outcomes: a systematic review and meta-analysis

Advantages of laparoscopic distal pancreatectomy: Systematic review and meta-analysis of randomized and matched studies

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