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. 2018 Sep;118(4):651-656.
doi: 10.1002/jso.25170. Epub 2018 Aug 16.

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

Mustafa Raoof  1 , Carolijn L M A Nota  1 , Laleh G Melstrom  1 , Susanne G Warner  1 , Yanghee Woo  1 , Gagandeep Singh  1 , Yuman Fong  1
Affiliations

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

Mustafa Raoof et al. J Surg Oncol. 2018 Sep.

Abstract

Background: How the oncologic outcomes after robotic distal pancreatectomy (RDP) compare to those after laparoscopic distal pancreatectomy (LDP) remains unknown.

Methods: Using the National Cancer Database (NCDB), we analyzed all patients undergoing LDP or RDP for resectable pancreatic adenocarcinoma over a 4-year period (2010-2013).

Results: Of the 704 eligible patients, 605 (86%) underwent LDP and 99 (14%) underwent RDP. The median follow-up for patients was 25 months. There were no differences in the two groups with respect to sociodemographic, clinicopathologic, or treatment characteristics. On comparing LDP versus RDP, there was no difference in the margin-positive rate (15% vs 16%; P = 0.84); lymph nodes examined (12 vs 11; P = 0.67); overall survival (hazard ratio [HR], 1.1, 95% confidence intervals [CI], 0.7 to 1.7; 28 vs 25 months; P = 0.71); hospital stay (6 vs 5 days; P = 0.14); time to chemotherapy (50 vs 52 days; P = 0.65); 30-day readmission (9.4% vs 9.1%; P = 0.92); and mortality (1% vs 0%; P = 0.28). Patients undergoing LDP had a significantly higher conversion rate to open or minimally invasive pancreatic cancer resections compared with RDP (27% vs 10%; P < 0.001).

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

Keywords: laparoscopy; minimally invasive surgery; pancreatic ductal adenocarcinoma; pancreatic resection; robotic surgery.

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Conflict of interest statement

Authors have no conflict of interest

Figures

Figure 1.
Figure 1.
Distribution of minimally invasive distal pancreatic resections across various hospitals grouped by quintiles of annual hospital volume status for all pancreatic resection (minimally invasive or open).
Figure 2.
Figure 2.
Kaplan-Meier overall survival estimates of patients undergoing minimally-invasive distal pancreatectomy (2010–2013) by Approach (LDP vs. RDP)
See this image and copyright information in PMC

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