Robotic-assisted versus open left pancreatectomy for cystic tumours: A single-centre experience

Luca Morelli, Gregorio Di Franco, Simone Guadagni, Matteo Palmeri, Niccoló Furbetta, Niccola Funel, Desirée Gianardi, Andrea De Palma, Luca Pollina, Andrea Moglia, Andrea Pietrabissa, Giulio Di Candio, Franco Mosca, Alfred Cuschieri

Research output: Contribution to journalArticle

Abstract

Background: Cystic pancreatic lesions (CPLs) are being identified increasingly, and some benefit from surgical treatment. With the increasing use of robotic-assisted surgery (RAS) for neoplasms of the pancreas, the aim of the present comparative study is to establish whether the RAS offered any advantages over conventional open surgery (OS) in the management of CPLs.

Patients and Methods: Twenty-seven out of 37 robot-assisted left-sided pancreatectomy (LSP) performed between January 2010 and April 2017 were carried out for CPLs. The surgical outcome and histopathology were compared retrospectively with a control group of 27 patients who had undergone open LSP for CPLs, selected using a one-to-one case-matched methodology (OS-Group) from the prospectively collected institutional database.

Results: The spleen was preserved in a significantly higher percentage of patients in the RAS-group (63% vs. 33.3%, P< 0.05). There was no difference in the post-operative course (pancreatic fistula and morbidity) between the two groups. The median post-operative hospital stay was significantly shorter in the RAS-group: 8 days (range 3-25) versus 12 days (range 7-26) in the OS-group (P < 0.01). No conversion to open approach was reported in the RAS-group.

Conclusions: Robotically assisted LSP is a safe and effective procedure. It is accompanied by a significantly higher spleen preservation rate compared to the open approach. In addition, because of the reduced trauma, RAS incurred a shorter post-operative hospital stay and faster return to full recovery, particularly important in patients undergoing surgery for relative indications. However, these benefits of RAS for LSP require confirmation by prospective randomised controlled studies.

Original languageEnglish
JournalJournal of Minimal Access Surgery
DOIs
Publication statusE-pub ahead of print - Sep 3 2018

Fingerprint

Pancreatectomy
Robotics
Neoplasms
Length of Stay
Spleen
Pancreatic Fistula
Pancreatic Neoplasms
Databases
Morbidity

Cite this

Robotic-assisted versus open left pancreatectomy for cystic tumours : A single-centre experience. / Morelli, Luca; Di Franco, Gregorio; Guadagni, Simone; Palmeri, Matteo; Furbetta, Niccoló; Funel, Niccola; Gianardi, Desirée; De Palma, Andrea; Pollina, Luca; Moglia, Andrea; Pietrabissa, Andrea; Di Candio, Giulio; Mosca, Franco; Cuschieri, Alfred.

In: Journal of Minimal Access Surgery, 03.09.2018.

Research output: Contribution to journalArticle

Morelli, L, Di Franco, G, Guadagni, S, Palmeri, M, Furbetta, N, Funel, N, Gianardi, D, De Palma, A, Pollina, L, Moglia, A, Pietrabissa, A, Di Candio, G, Mosca, F & Cuschieri, A 2018, 'Robotic-assisted versus open left pancreatectomy for cystic tumours: A single-centre experience', Journal of Minimal Access Surgery. https://doi.org/10.4103/jmas.JMAS_158_18
Morelli, Luca ; Di Franco, Gregorio ; Guadagni, Simone ; Palmeri, Matteo ; Furbetta, Niccoló ; Funel, Niccola ; Gianardi, Desirée ; De Palma, Andrea ; Pollina, Luca ; Moglia, Andrea ; Pietrabissa, Andrea ; Di Candio, Giulio ; Mosca, Franco ; Cuschieri, Alfred. / Robotic-assisted versus open left pancreatectomy for cystic tumours : A single-centre experience. In: Journal of Minimal Access Surgery. 2018.
@article{ed76f4f691084e049cc0db8fcf4bb539,
title = "Robotic-assisted versus open left pancreatectomy for cystic tumours: A single-centre experience",
abstract = "Background: Cystic pancreatic lesions (CPLs) are being identified increasingly, and some benefit from surgical treatment. With the increasing use of robotic-assisted surgery (RAS) for neoplasms of the pancreas, the aim of the present comparative study is to establish whether the RAS offered any advantages over conventional open surgery (OS) in the management of CPLs.Patients and Methods: Twenty-seven out of 37 robot-assisted left-sided pancreatectomy (LSP) performed between January 2010 and April 2017 were carried out for CPLs. The surgical outcome and histopathology were compared retrospectively with a control group of 27 patients who had undergone open LSP for CPLs, selected using a one-to-one case-matched methodology (OS-Group) from the prospectively collected institutional database.Results: The spleen was preserved in a significantly higher percentage of patients in the RAS-group (63{\%} vs. 33.3{\%}, P< 0.05). There was no difference in the post-operative course (pancreatic fistula and morbidity) between the two groups. The median post-operative hospital stay was significantly shorter in the RAS-group: 8 days (range 3-25) versus 12 days (range 7-26) in the OS-group (P < 0.01). No conversion to open approach was reported in the RAS-group.Conclusions: Robotically assisted LSP is a safe and effective procedure. It is accompanied by a significantly higher spleen preservation rate compared to the open approach. In addition, because of the reduced trauma, RAS incurred a shorter post-operative hospital stay and faster return to full recovery, particularly important in patients undergoing surgery for relative indications. However, these benefits of RAS for LSP require confirmation by prospective randomised controlled studies.",
author = "Luca Morelli and {Di Franco}, Gregorio and Simone Guadagni and Matteo Palmeri and Niccol{\'o} Furbetta and Niccola Funel and Desir{\'e}e Gianardi and {De Palma}, Andrea and Luca Pollina and Andrea Moglia and Andrea Pietrabissa and {Di Candio}, Giulio and Franco Mosca and Alfred Cuschieri",
year = "2018",
month = "9",
day = "3",
doi = "10.4103/jmas.JMAS_158_18",
language = "English",
journal = "Journal of Minimal Access Surgery",
issn = "0972-9941",
publisher = "Medknow Publications and Media Pvt. Ltd",

}

TY - JOUR

T1 - Robotic-assisted versus open left pancreatectomy for cystic tumours

T2 - A single-centre experience

AU - Morelli, Luca

AU - Di Franco, Gregorio

AU - Guadagni, Simone

AU - Palmeri, Matteo

AU - Furbetta, Niccoló

AU - Funel, Niccola

AU - Gianardi, Desirée

AU - De Palma, Andrea

AU - Pollina, Luca

AU - Moglia, Andrea

AU - Pietrabissa, Andrea

AU - Di Candio, Giulio

AU - Mosca, Franco

AU - Cuschieri, Alfred

PY - 2018/9/3

Y1 - 2018/9/3

N2 - Background: Cystic pancreatic lesions (CPLs) are being identified increasingly, and some benefit from surgical treatment. With the increasing use of robotic-assisted surgery (RAS) for neoplasms of the pancreas, the aim of the present comparative study is to establish whether the RAS offered any advantages over conventional open surgery (OS) in the management of CPLs.Patients and Methods: Twenty-seven out of 37 robot-assisted left-sided pancreatectomy (LSP) performed between January 2010 and April 2017 were carried out for CPLs. The surgical outcome and histopathology were compared retrospectively with a control group of 27 patients who had undergone open LSP for CPLs, selected using a one-to-one case-matched methodology (OS-Group) from the prospectively collected institutional database.Results: The spleen was preserved in a significantly higher percentage of patients in the RAS-group (63% vs. 33.3%, P< 0.05). There was no difference in the post-operative course (pancreatic fistula and morbidity) between the two groups. The median post-operative hospital stay was significantly shorter in the RAS-group: 8 days (range 3-25) versus 12 days (range 7-26) in the OS-group (P < 0.01). No conversion to open approach was reported in the RAS-group.Conclusions: Robotically assisted LSP is a safe and effective procedure. It is accompanied by a significantly higher spleen preservation rate compared to the open approach. In addition, because of the reduced trauma, RAS incurred a shorter post-operative hospital stay and faster return to full recovery, particularly important in patients undergoing surgery for relative indications. However, these benefits of RAS for LSP require confirmation by prospective randomised controlled studies.

AB - Background: Cystic pancreatic lesions (CPLs) are being identified increasingly, and some benefit from surgical treatment. With the increasing use of robotic-assisted surgery (RAS) for neoplasms of the pancreas, the aim of the present comparative study is to establish whether the RAS offered any advantages over conventional open surgery (OS) in the management of CPLs.Patients and Methods: Twenty-seven out of 37 robot-assisted left-sided pancreatectomy (LSP) performed between January 2010 and April 2017 were carried out for CPLs. The surgical outcome and histopathology were compared retrospectively with a control group of 27 patients who had undergone open LSP for CPLs, selected using a one-to-one case-matched methodology (OS-Group) from the prospectively collected institutional database.Results: The spleen was preserved in a significantly higher percentage of patients in the RAS-group (63% vs. 33.3%, P< 0.05). There was no difference in the post-operative course (pancreatic fistula and morbidity) between the two groups. The median post-operative hospital stay was significantly shorter in the RAS-group: 8 days (range 3-25) versus 12 days (range 7-26) in the OS-group (P < 0.01). No conversion to open approach was reported in the RAS-group.Conclusions: Robotically assisted LSP is a safe and effective procedure. It is accompanied by a significantly higher spleen preservation rate compared to the open approach. In addition, because of the reduced trauma, RAS incurred a shorter post-operative hospital stay and faster return to full recovery, particularly important in patients undergoing surgery for relative indications. However, these benefits of RAS for LSP require confirmation by prospective randomised controlled studies.

U2 - 10.4103/jmas.JMAS_158_18

DO - 10.4103/jmas.JMAS_158_18

M3 - Article

C2 - 30178768

JO - Journal of Minimal Access Surgery

JF - Journal of Minimal Access Surgery

SN - 0972-9941

ER -