Short-term and long-term outcomes after robot-assisted versus laparoscopic distal pancreatectomy for pancreatic neuroendocrine tumors (pNETs): a multicenter comparative study

The Italian Robotic pNET Group

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Minimally invasive surgery has increasingly gained popularity as a treatment of choice for pancreatectomy with encouraging initial results in robotic distal pancreatectomy (RDP). However, few data are available on the comparison between RDP and laparoscopic distal pancreatectomy (LDP) for pancreatic neuroendocrine tumors (pNETs). Our aim, thus, is to compare perioperative and long-term outcomes as well as total costs of RDP and LDP for pNETs. Methods: All RDPs and LDPs for pNETs performed in four referral centers from 2008 to 2016 were included. Perioperative outcomes, histopathological results, overall (OS) and disease-free survival (DFS), and total costs were evaluated. Results: Ninety-six RDPs and 85 LDPs were included. Demographic and clinical characteristics were comparable between the two cohorts. Operative time was 36.5 min longer in the RDP group (p = 0.009) but comparable to LDP after removing the docking time (247.9 vs 233.7 min; p = 0.6). LDP related to a lower spleen preservation rate (44.7% vs 65.3%; p < 0.0001) and higher blood loss (239.7 ± 112 vs 162.5 ± 98 cc; p < 0.0001). Advantages in operative time for RDP were documented in case of the spleen preservation procedures (265 ± 41.52 vs 291 ± 23 min; p = 0.04). Conversion rate, postoperative morbidity, and pancreatic fistula rate were similar between the two groups, as well as histopathological data, OS, and DFS. Significant advantages were evidenced for LDP regarding mean total costs (9235 (± 1935) € vs 11,226 (± 2365) €; p < 0.0001). Conclusions: Both RDP and LDP are safe and efficacious for pNETs treatment. However, RDP offers advantages with a higher spleen preservation rate and lower blood loss. Costs still remain the main limitation of the robotic approach.

Original languageEnglish
JournalLangenbeck's Archives of Surgery
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Pancreatectomy
Neuroendocrine Tumors
Multicenter Studies
Robotics
Costs and Cost Analysis
Spleen
Operative Time
Disease-Free Survival
Pancreatic Fistula
Minimally Invasive Surgical Procedures

Keywords

  • Long-term outcomes
  • Minimally invasive
  • Pancreatic neuroendocrine tumors
  • Robot-assisted pancreatectomy

ASJC Scopus subject areas

  • Surgery

Cite this

@article{d2d3cb707112495db4a1ea11959bee4e,
title = "Short-term and long-term outcomes after robot-assisted versus laparoscopic distal pancreatectomy for pancreatic neuroendocrine tumors (pNETs): a multicenter comparative study",
abstract = "Purpose: Minimally invasive surgery has increasingly gained popularity as a treatment of choice for pancreatectomy with encouraging initial results in robotic distal pancreatectomy (RDP). However, few data are available on the comparison between RDP and laparoscopic distal pancreatectomy (LDP) for pancreatic neuroendocrine tumors (pNETs). Our aim, thus, is to compare perioperative and long-term outcomes as well as total costs of RDP and LDP for pNETs. Methods: All RDPs and LDPs for pNETs performed in four referral centers from 2008 to 2016 were included. Perioperative outcomes, histopathological results, overall (OS) and disease-free survival (DFS), and total costs were evaluated. Results: Ninety-six RDPs and 85 LDPs were included. Demographic and clinical characteristics were comparable between the two cohorts. Operative time was 36.5 min longer in the RDP group (p = 0.009) but comparable to LDP after removing the docking time (247.9 vs 233.7 min; p = 0.6). LDP related to a lower spleen preservation rate (44.7{\%} vs 65.3{\%}; p < 0.0001) and higher blood loss (239.7 ± 112 vs 162.5 ± 98 cc; p < 0.0001). Advantages in operative time for RDP were documented in case of the spleen preservation procedures (265 ± 41.52 vs 291 ± 23 min; p = 0.04). Conversion rate, postoperative morbidity, and pancreatic fistula rate were similar between the two groups, as well as histopathological data, OS, and DFS. Significant advantages were evidenced for LDP regarding mean total costs (9235 (± 1935) € vs 11,226 (± 2365) €; p < 0.0001). Conclusions: Both RDP and LDP are safe and efficacious for pNETs treatment. However, RDP offers advantages with a higher spleen preservation rate and lower blood loss. Costs still remain the main limitation of the robotic approach.",
keywords = "Long-term outcomes, Minimally invasive, Pancreatic neuroendocrine tumors, Robot-assisted pancreatectomy",
author = "{The Italian Robotic pNET Group} and Sergio Alfieri and Giovanni Butturini and Ugo Boggi and Andrea Pietrabissa and Luca Morelli and Fabio Vistoli and Isacco Damoli and Andrea Peri and Claudio Fiorillo and Luigi Pugliese and Marco Ramera and {De Lio}, Nelide and {Di Franco}, Gregorio and Alessandro Esposito and Luca Landoni and Fausto Rosa and Roberta Menghi and Doglietto, {Giovanni Battista} and Giuseppe Quero",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00423-019-01786-x",
language = "English",
journal = "Langenbeck's Archives of Surgery",
issn = "1435-2443",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Short-term and long-term outcomes after robot-assisted versus laparoscopic distal pancreatectomy for pancreatic neuroendocrine tumors (pNETs)

T2 - a multicenter comparative study

AU - The Italian Robotic pNET Group

AU - Alfieri, Sergio

AU - Butturini, Giovanni

AU - Boggi, Ugo

AU - Pietrabissa, Andrea

AU - Morelli, Luca

AU - Vistoli, Fabio

AU - Damoli, Isacco

AU - Peri, Andrea

AU - Fiorillo, Claudio

AU - Pugliese, Luigi

AU - Ramera, Marco

AU - De Lio, Nelide

AU - Di Franco, Gregorio

AU - Esposito, Alessandro

AU - Landoni, Luca

AU - Rosa, Fausto

AU - Menghi, Roberta

AU - Doglietto, Giovanni Battista

AU - Quero, Giuseppe

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: Minimally invasive surgery has increasingly gained popularity as a treatment of choice for pancreatectomy with encouraging initial results in robotic distal pancreatectomy (RDP). However, few data are available on the comparison between RDP and laparoscopic distal pancreatectomy (LDP) for pancreatic neuroendocrine tumors (pNETs). Our aim, thus, is to compare perioperative and long-term outcomes as well as total costs of RDP and LDP for pNETs. Methods: All RDPs and LDPs for pNETs performed in four referral centers from 2008 to 2016 were included. Perioperative outcomes, histopathological results, overall (OS) and disease-free survival (DFS), and total costs were evaluated. Results: Ninety-six RDPs and 85 LDPs were included. Demographic and clinical characteristics were comparable between the two cohorts. Operative time was 36.5 min longer in the RDP group (p = 0.009) but comparable to LDP after removing the docking time (247.9 vs 233.7 min; p = 0.6). LDP related to a lower spleen preservation rate (44.7% vs 65.3%; p < 0.0001) and higher blood loss (239.7 ± 112 vs 162.5 ± 98 cc; p < 0.0001). Advantages in operative time for RDP were documented in case of the spleen preservation procedures (265 ± 41.52 vs 291 ± 23 min; p = 0.04). Conversion rate, postoperative morbidity, and pancreatic fistula rate were similar between the two groups, as well as histopathological data, OS, and DFS. Significant advantages were evidenced for LDP regarding mean total costs (9235 (± 1935) € vs 11,226 (± 2365) €; p < 0.0001). Conclusions: Both RDP and LDP are safe and efficacious for pNETs treatment. However, RDP offers advantages with a higher spleen preservation rate and lower blood loss. Costs still remain the main limitation of the robotic approach.

AB - Purpose: Minimally invasive surgery has increasingly gained popularity as a treatment of choice for pancreatectomy with encouraging initial results in robotic distal pancreatectomy (RDP). However, few data are available on the comparison between RDP and laparoscopic distal pancreatectomy (LDP) for pancreatic neuroendocrine tumors (pNETs). Our aim, thus, is to compare perioperative and long-term outcomes as well as total costs of RDP and LDP for pNETs. Methods: All RDPs and LDPs for pNETs performed in four referral centers from 2008 to 2016 were included. Perioperative outcomes, histopathological results, overall (OS) and disease-free survival (DFS), and total costs were evaluated. Results: Ninety-six RDPs and 85 LDPs were included. Demographic and clinical characteristics were comparable between the two cohorts. Operative time was 36.5 min longer in the RDP group (p = 0.009) but comparable to LDP after removing the docking time (247.9 vs 233.7 min; p = 0.6). LDP related to a lower spleen preservation rate (44.7% vs 65.3%; p < 0.0001) and higher blood loss (239.7 ± 112 vs 162.5 ± 98 cc; p < 0.0001). Advantages in operative time for RDP were documented in case of the spleen preservation procedures (265 ± 41.52 vs 291 ± 23 min; p = 0.04). Conversion rate, postoperative morbidity, and pancreatic fistula rate were similar between the two groups, as well as histopathological data, OS, and DFS. Significant advantages were evidenced for LDP regarding mean total costs (9235 (± 1935) € vs 11,226 (± 2365) €; p < 0.0001). Conclusions: Both RDP and LDP are safe and efficacious for pNETs treatment. However, RDP offers advantages with a higher spleen preservation rate and lower blood loss. Costs still remain the main limitation of the robotic approach.

KW - Long-term outcomes

KW - Minimally invasive

KW - Pancreatic neuroendocrine tumors

KW - Robot-assisted pancreatectomy

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U2 - 10.1007/s00423-019-01786-x

DO - 10.1007/s00423-019-01786-x

M3 - Article

AN - SCOPUS:85065222135

JO - Langenbeck's Archives of Surgery

JF - Langenbeck's Archives of Surgery

SN - 1435-2443

ER -